Home » Employment Opportunities » Form: Application for Employment

Application for Employment

Employment Application

"*" indicates required fields

Please complete our online employment application. The UVS Human Resources department will contact you if your application materials match current position openings.

Upstate Veterinary Specialties is an Equal Opportunity Employer; and does not discriminate on the basis of race, color, sex, sexual orientation, creed, age, religion, ancestry, marital status, national origin, ancestry, disability, genetic information, citizenship status, veteran status or any other characteristic or status protected by applicable law. We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please let us know.

General Information

Date*

Legal Name*

First Middle Last

Preferred Name

First Middle Last

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Primary Number*

Email*

Have you ever applied here before?*

Yes

Position Applying For:*

Salary desired*

Are you looking for full-time or part-time?*

Full-time

Part-time

Date available*

Days available*

Check all that apply. (Use CTRL + Mouse to make multiple selections.)

Times available*

Check all that apply. (Use CTRL + Mouse to make multiple selections.)

If you are under 18 years of age, do you have the necessary permit(s) for employment?*

Yes

Work Experience

List most recent first.

Employer*

Supervisor*

Employer Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone*

May we contact your current employer?*

Yes

Date started*

Date left

Current Employment Status

Still employed

Starting Position*

Last Position*

Duties*

Reason for leaving*

Work Experience

Employer*

Supervisor*

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Phone*

Date started*

Date left*

Starting Position*

Last Position*

Duties*

Reason for Leaving*

Work Experience

Employer*

Supervisor*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone*

Date started*

Date left*

Starting Position*

Last Position*

Duties*

Reason for leaving*

Professional References

(not related to you)

Reference One:

First Last

Job Title*

Phone*

How acquainted?*

How long?*

Reference Two:

First Last

Job Title*

Phone*

How acquainted?*

How long?*

Education and Training

College

Name and Address

Years Completed

Degree

Course Major

High School

Name and Address

Years Completed

Degree

Course Major

Vocational School

Name and Address

Years Completed

Degree

Course Major

Professional Licenses/Memberships

(include type and dates held)

Indicate the job skills which you have performed:*

Computers/Software

Additional Work History Inquiries

Have you been convicted of a crime? (expunged, sealed, pardoned, annulled and discharged, and juvenile convictions need not be disclosed)*

NOTE: Convictions will not necessarily disqualify applicant, each case is considered individually.

Yes

If yes, please explain

Are you legally authorized to work in the US? (If hired, verification of employment authorization and eligibility to work in the US will be required, consistent with federal law and as required by INS Form I-9.)*

Yes

Why are you interested in working for our company?*

What strengths would you bring to our company?*

What didn't you like about your previous jobs?*

Please upload your resume here:

A cover letter is optional to upload another file, click select files again.

Drop files here or

Max. file size: 25 MB.

Applicant's Statement

I have read and fully understand the questions asked in this application. I certify that all of the answers I have given are true, accurate, and complete. I understand that the omission and/or misrepresentation of any fact from or on this application or during any interview will result in immediate rejection of my application or if I am hired will be cause for immediate dismissal. Unless I noted otherwise, I authorize Upstate Veterinary Specialties, PLLC to contact all my employment and professional references, as well as the education institutions I have attended. I further authorize Upstate Veterinary Specialties, PLLC to inquire about, investigate, and obtain copies of any records which relate to me from my former employers and educational institutions. I hereby release Upstate Veterinary Specialties, PLLC, and all affiliated persons and entities, as well as any person or institution that provides Upstate Veterinary Specialties, PLLC with any lawful information about me, from any and all liability whatsoever resulting from any such lawful inquiry, investigation or communication.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules, and regulations of employment at Upstate Veterinary Specialties, PLLC as outlined in the company's Employment Handbook. However, I further understand that neither this application, the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an offer, a contract, or a guarantee of employment for a specific period of time. I understand that any employment offered is "at-will" and that either I or Upstate Veterinary Specialties, PLLC may terminate my employment at any time with or without notice or cause.

Name*

Date*

This field is for validation purposes and should be left unchanged.