CVS Employment Application - Free Download
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CVS Employment Application
CVS Employment Application
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CVS EMPLOYMENT APPLICATION
31310 Woodhaven Trail Cannon Falls, MN 55009
651-258-4050 fax 651-258-4051 email: Drtomwinter@cannonvet.com
TO APPLICANT: Thank you for your interest in Cannon Veterinary Services Ltd. and for
taking time to provide us with your background and work history. This information is necessary
to assist us in placing you in a position that best meets your qualifications.
PERSONAL Date_________, 20_________
Name________________________________ Birth date__________ Soc. Sec. # ________________________
Home#________________ Cell# ________________ Driver License#_________________________________
Present Address________________________________City___________________State_______Zip________
Permanent Address_____________________________City______________________State_______Zip______
Position applied for__________________________________________________________________________
Do you prefer Full Time______ Part Time_______ If part time, days & hours________________________
Date available for work_____________________________ Salary desired_____________________________
How did you hear about this position ___________________________________________________________
Have you been convicted of a felony within the last five years Yes__ No__ If yes,
Explain___________________________________________________________________________________
Have you ever been suspended or discharged for cause Yes__ No___ If yes,
Explain____________________________________________________________________________________
__________________________________________________________________________________________
MEDICAL HISTORY
Date of last health exam_________________________ Purpose_____________________________________
Are you willing to take a physical exam Yes___ No___
How much time have you lost through illness in the past 2 years ______________________________________
What was the reason _______________________ _________________________________________________
Do you have any physical impairment Yes___No___ If yes, Explain___________________________________
Have you ever been hospitalized Yes___ No___ If yes, did it affect job performance____________________
give dates & causes: _________________________________________________________________________
_
SPECIALIZED SKILLS AND EXPERIENCE
Explain your receptionist skills
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
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