Employment Application

The Tupelo Lee Humane Society is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process he or she should contact a company representative.

Please complete the following information:

Applicant Information

Date of Application(Required)

Applicant Name(Required)

First Last

Applicant SSN#(Required)

Applicant Birthdate(Required)

Address(Required)

Street Address City State ZIP Code

Phone(Required)

Email(Required)

Emergency Contact(s)

Emergency Contact(s) Phone Number(s)

Employment Position

Position(s) applying for(Required)

How did you hear about this position?(Required)

If needed, are you available to work overtime?(Required)

Yes

On what date can you start working if you are hired?(Required)

Do you have reliable transportation to and from work?(Required)

Yes

Salary Desired

Personal Information

Have you ever applied to or worked for Tupelo Lee Humane Society before?(Required)

Yes

If yes, when?

Do you have any friends, relatives, or acquaintances working for Tupelo Lee Humane Society?(Required)

Yes

If yes, who?

Are you a U.S. citizen or approved to work in the United States?(Required)

Yes

Will you consent to a mandatory controlled substance test?(Required)

Yes

Job Skills/Qualifications

Please list below the skills and qualifications you possess for which you are applying:(Required)

(Note: The Tupelo Lee Humane Society complies with ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)

Education and Training

High School/GED(Required)

College/University

Vocational/Specialized Training

Are you currently employed?(Required)

Yes

If yes:

What company?

Supervisor

Previous Employment

Previous Employer One

Employer/Company

Supervisor Name

Dates Employed

Reason for leaving

Previous Employer Two

Employer/Company

Supervisor Name

Dates Employed

Reason for leaving

Previous Employer Three

Employer/Company

Supervisor Name

Dates Employed

Reason for leaving

Do you have any known medical or physical limitations that may affect your abilit to work for TLHS?(Required)

Yes

By signing below, you acknowledge that all information provided above is true and accurate to the best of your knowledge and that TLHS may terminate employment based on false information provided above.

Applicant Signature(Required)

Feel free to attach a resume if wanted

Accepted file types: pdf, Max. file size: 32 MB.

CAPTCHA

Comments

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

Applicant Information

Employment Position

Personal Information

Job Skills/Qualifications

Education and Training

Previous Employment

Contact

Connect