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Home | About Us | Employment Application

Employment Application

An Equal Opportunity Employer. Atlanta Humane Society shall not discriminate on the basis of age, sex, race, color, creed, national origin, religion or disability with regard to receipt of services, hiring or promotion in staff positions, or board positions.

If you prefer to mail in your application, please download the PDF attachment below.
adobe reader employment.application.pdf
Name *

First
Last
Date Time *

MM 		/
DD 		/
YYYY
Alias Name

First
Last
Address *

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Phone (Preferred)

### 		-
### 		-
####
Phone (Other)

### 		-
### 		-
####
Email *
Position Applied for *
Desired Salary *
Date Available

MM 		/
DD 		/
YYYY
Days/Hours Available to Work *
Able to Work Overtime?
*More than 40 hours/week *
 Yes 
 No 
Are you 18 years of age or older?
*If no, you may be required to provide authorization to work *
 Yes 
 No 
Are you authorized to work in the United States? *
 Yes 
 No 
Have you worked with AHS before? *
 Yes 
 No 
If so, Position? When?
Have you applied with AHS before? *
 Yes 
 No 
If so, Position? Supervisor? When?

EDUCATION:

High School Name *
City, State *
Degree Earned *
College School Name *
City, State *
Degree Earned *
Other Name
City, State
Degree Earned

Employment:

Current Employer
Company Name *
*May we contact? *
 Yes 
 No 
Title/Position *
Dates of Employment *
Phone *

### 		-
### 		-
####
City/State *
Supervisorʼs Name/Title *
Duties & Responsibilities *
Full Time/Part Time *
Salary *
Reason for Leaving *

Employer #2
Company Name *
Title/Position *
Dates of Employment *
Phone *

### 		-
### 		-
####
City/State *
Supervisorʼs Name/Title *
Duties & Responsibilities *
Full Time/Part Time *
Salary *
Reason for Leaving *

Employer #3
Company Name *
Title/Position *
Dates of Employment *
Phone *

### 		-
### 		-
####
City/State *
Supervisorʼs Name/Title *
Duties & Responsibilities *
Full Time/Part Time *
Salary *
Reason for Leaving *

Employer #4
Company Name *
Title/Position *
Dates of Employment *
Phone *

### 		-
### 		-
####
City/State *
Supervisorʼs Name/Title *
Duties & Responsibilities *
Full Time/Part Time *
Salary *
Reason for Leaving *

Employer #5
Company Name *
Title/Position *
Dates of Employment *
Phone *

### 		-
### 		-
####
City/State *
Supervisorʼs Name/Title *
Duties & Responsibilities *
Full Time/Part Time *
Salary *
Reason for Leaving *
Special Training/Certificates/Licenses *
Special Skills *
Served in US Armed Forces?
If yes, Branch
Rank
Discharge Date
How did you hear about this position? *
If referred, by who?

First
Last
Do you know or are you related to anyone who works for AHS? *
If so, who? *

First
Last
Have you ever been convicted of a felony/crime other than minor traffic offense? *
 Yes 
 No 
Nature of Crime *
Date of Conviction *

MM 		/
DD 		/
YYYY
County/State of Conviction *

**Conviction of a crime will not automatically disqualify you from the job for which you are applying. Each conviction will be considered in respect to date of conviction, job relatedness and other relevant factors.

Professional/Personal Reference:

Name *

First
Last
Relationship *
Years Known *
Phone *

### 		-
### 		-
####
Email *

Professional/Personal Reference:

Name *

First
Last
Relationship *
Years Known *
Phone *

### 		-
### 		-
####
Email *

Professional/Personal Reference:

Name *

First
Last
Relationship *
Years Known *
Phone *

### 		-
### 		-
####
Email *

Atlanta Humane Society is an Equal Opportunity Employer. I understand that this application is not an offer of employment, does not mean that any positions are available and does not guarantee that I will be offered a job. I also understand that if hired, the Atlanta Humane Society may change the terms and conditions of my employment if necessary and appropriate, that any employment is for a indefinite period of time, and that both the Atlanta Humane Society and I have the freedom to terminate such employment relationship whenever either chooses to do so, with or without cause and with or without notice. I further understand and acknowledge that no representative of the Atlanta Humane Society, other than the President, has any authority to enter into any agreement that is contrary to the language of this paragraph.

I understand that material omissions or false statements on this application may be considered sufficient cause for denial of employment or immediate dismissal, if and when discovered.

I also authorize the Atlanta Humane Society to contact the references and former employers listed.

I understand that I may be required to undergo a drug screening test and background investigation as part of the employment process. An offer of employment will be withdrawn when the results of the drug screening test are positive for illegal drugs or for the presence of prescription drugs (i.e. barbiturates, amphetamines, opiates) unless I have a valid
medical explanation for the positive result.
Electronic Signature *

First
Last
Date Time *

MM 		/
DD 		/
YYYY
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