Please fill out the form completely. Applicants may be tested for illegal drugs. We are an equal opportunity employer, dedicated to a policy of non‐discrimination in employment on any basis including race, color, age, sex, religion, handicap, disability, sexual orientation, national origin, or any other characteristic protected by applicable federal, state, or local law. No question on this application is used for the purpose of limiting or excluding any applicant’s consideration for employment on any basis prohibited by federal, state or local laws. It is Valley West Veterinary hospital’s policy not to refuse to hire a qualified individual with a disability because of that person’s need for a reasonable accommodation as provided under the Americans with Disabilities Act or other applicable laws.

First

Middle

Last

Email Address

Have you ever been employed or enrolled in school under a name other than that used on this application? If so please specify.

Mailing Address

Mailing Address 2

City/Town

State/Province

ZIP/Postal Code

Home Phone

Cell Phone

How did you hear about us?

What position are you applying for?

Employment Desired

Full time only

Part time only

Full or part time

For part‐time, please indicate hours per week desired.

When can you start?

Salary desired?

Are you employed now?

Yes

May we contact your present employer?

Yes

Have you ever applied with VWVH before?

Yes

Are you able to work overtime?

Yes

Are you legally eligible for employment in the USA?

Yes

All new hires will be required to provide proof of eligibility to work in the USA.

Have you ever pled "guilty" or "no contest" to or been convicted of a felony?

Yes

Have you been convicted of a misdemeanor in the last seven years?

Yes

If yes to either, please explain.

If necessary for the job, are you able to provide a valid driver's license?

Yes

When are you able to work?

Sun

Mon

Tue

Wed

Thur

Fri

Sat

Please specify hours on each day.

Professional Licenses, Certifications or Registrations:

Additional skills including but not limited to computer, math, typing, supervisory, language, or any other information regarding the career you wish to bring to our attention. Please list veterinary software you have used.

Education

High School:

Address:

Diploma

Yes

College/ University Name:

Address:

Degree Received:

Other (Graduate, Technical):

Address:

Degree Received:

References

Please list 3 professional references that you have known for at least 1 year. Do not include relatives.

Name and occupation

Address:

Phone Number:

Name and occupation

Address:

Phone Number:

Name and occupation

Address:

Phone Number:

Employment History

List your employers, starting with your most recent one first. Please include any non-paid/volunteer experience which is related to the job for which you are applying. Be sure all your experience or employers related to this job are listed here or use an extra paper if necessary.

Previous Employer 1

Name of Employer

Address

May we contact for a reference?

Yes

Later

Start Date

End Date

Reason for Leaving

Job Title

Supervisor's Name and Title

Phone Number

Starting Salary

Final Salary

List the jobs you held, duties performed, skills used or learned, or promotions while you worked at this company.

Previous Employer 2

Name of Employer

Address

May we contact for a reference?

Yes

Later

Start Date

End Date

Reason for Leaving

Job Title

Supervisor's Name and Title

Phone Number

Starting Salary

Final Salary

List the jobs you held, duties performed, skills used or learned, or promotions while you worked at this company.

Previous Employer 3

Name of Employer

Address

May we contact for a reference?

Yes

Later

Start Date

End Date

Reason for Leaving

Job Title

Supervisor's Name and Title

Phone Number

Starting Salary

Final Salary

List the jobs you held, duties performed, skills used or learned, or promotions while you worked at this company.

Why do you want to work for Valley West Veterinary Hospital?

Did you complete this application yourself?

Yes

If not, who did

I hereby certify that the information contained on this application, or any other information I submit to VWVH in connection with my application for employment, is true and correct to the best of my knowledge and agree to have any such statements or information checked by VWVH. I authorize VWVH to make a thorough investigation of my references, past employment, education, criminal background, and to secure additional job‐related information about me. I also authorize the references listed above, as well as all other individuals whom VWVH contacts, to provide VWVH with any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to VWVH as well as from any use or disclosure of such information by VWVH or any of its agents, employees or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application, or any other information I submit to VWVH in connection with my application for employment, may result in my failure to receive an offer or, if I am hired, my immediate dismissal from employment. I understand that filling out this form does not indicate that there is a position open and does not obligate VWVH to hire me.

I understand that if I am hired by VWVH, my employment will be “at‐will” and, just as I will be free to resign at any time, the Company reserves the right to terminate my employment at anytime, with or without cause and without prior notice. I understand that no employee or representative of VWVH has any authority to enter into a contract of employment, express or implied, that changes or modifies in any way such employment at‐will. I have read, understand, and by my signature consent to these statements.

Signature

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We will be closed on December 24 and December 25 in honor of Christmas. We will be open regular hours on Friday, December 26, 2025. Please reach out to Kanawha Valley Veterinary Emergency Hospital if your pet is facing an emergency while we are closed.

Employment Application

Previous Employer 1

Previous Employer 2

Previous Employer 3

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