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Position applying for: Registered Veterinary Technician

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POSITION

Position(s) applied for: 1.   2.
I understand that applicants who do not meet the minimum qualifications of the position will not be considered for the position. Only those final candidates will be contacted.
Specify: Full-time   Part-time   Temporary Part Time   PRN Salary Requirement:
Shift Preferred: Day   Evening   Night
Degrees and Certifications: RVT   BS   PHD   DVM   CES   Equine Acupuncture   ABVP   Dental

HORSE EXPERIENCE

List your specific experience with horses, including whether you have owned a horse, ridden horses, and/or cared for horses, and when and where.

PERSONAL

* First Name: ( required )
* Last Name: ( required )
Middle:
Date:
December 11, 2017
* Street Address: ( required )
* City, State, Zip: ( required )
* Email: ( required )
* Home Phone: ( required )
Business Phone:
Cell Phone:
Please Note: Mid-Rivers communicates primarily by email so please include an email address which you actively check

EMPLOYMENT

Please give accurate, complete full-time and part-time employment record. Start with present or most recent employer.
1.
Company Name:
Telephone:
Address:
City, State, Zip:
Employed: (State Month and Year)
From:   To:
Name of Supervisor:
Salary:
From:   To:
State Job Title and Describe Your Work Reason for Leaving
2.
Company Name:
Telephone:
Address:
City, State, Zip:
Employed: (State Month and Year)
From:   To:
Name of Supervisor:
Salary:
From:   To:
State Job Title and Describe Your Work Reason for Leaving
3.
Company Name:
Telephone:
Address:
City, State, Zip:
Employed: (State Month and Year)
From:   To:
Name of Supervisor:
Salary:
From:   To:
State Job Title and Describe Your Work Reason for Leaving

We may contact the employers listed above unless you indicate those you do not want us to contact.
DO NOT CONTACT:
Employer Number:   Reason:
Employer Number:   Reason:
Employer Number:   Reason:

EDUCATION

School
Name & Location of School
Course of Study
Years Completed
Did you Graduate?
Degree or Diploma
School
Name & Location of School
Course of Study
Years Completed
Did you Graduate?
Degree or Diploma

REFERENCES (PLEASE DO NOT LIST RELATIVES)

Name
Occupation
Address
City, State, Zip
Phone No.
Name
Occupation
Address
City, State, Zip
Phone No.

I understand that any omission, misrepresentation or falsification can be grounds for refusal of employment. I further understand that, if employed, any false statements or misrepresentations herein or in conjunction with the application process may be cause for dismissal.
* Applicant Name: ( required )   Date: 12/11/17
To assist us in finding the proper position for you, use the space below to summarize any additional information to describe your full qualifications.
Submission of this application indicates your acceptance of our policies and guidelines regarding employment.

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