*NAH Job Application

Pre-Employment Questionnaire

Thank you for your interest in working with Newberry Animal Hospital Group!

Date

2025

Name

Home Phone

Cell Phone

Present Address

Permanent Address

Customer Service Representative

If you are applying after learning about a job posting, please indicate where this job posting was found:

Monster

Indeed

Zip Recruiter

Glassdoor

Facebook Job posting

Facebook 'Job Fair Event' posting

Vet industry organization Ad (AVMA, etc)

NAH paper flyer

Gainesville or Newberry Chamber

I don't know about a job posting.

A NAH employee referred me

Other:

NAH employee that referred me:

Any Location

Salary or Hourly Rate Desired?

What would you like your tentative start-date be, if offered a position with NAH?

YYYY

What is your current employment status?

Employed

Self-Employed

Unemployed

Student

May we inquire with your present employer?

Yes

Are you looking for Part-time or Full-time?

Prefer Part-time

Prefer Full-time

Flexible

EDUCATION/TRAINING:

EDUCATION HISTORY:
High School: Names/Location
Years attended, Subjects studied

High School: Did you graduate?

Yes

GED

In high school currently.

College:
Name and location, years attended,
Subjects studied-

College: Did you graduate?

Yes

In college currently.

Trade or Business School:
Name and location, years attended,
Subjects studied-

Trade/Business School: Did you graduate?

Yes

In college currently.

Please use this area to list any Military Duty/Type of Discharge, awards, or other special study, training, skills or research work not mentioned above.

REFERENCES:

PLEASE LIST AT LEAST TWO (2) REFERENCES HERE:

1. Name

Relationship to you?

Phone

2. Name

Relationship to you:

Phone

3. Name

Relationship to you:

Phone number

CURRENT/FORMER EMPLOYERS:
#1 NAME & ADDRESS OF EMPLOYER (MOST RECENT FIRST)

PLEASE INCLUDE DATES OF EMPLOYMENT, SALARY, POSITION, AND REASON FOR LEAVING:

Relationship to you:

Phone

EMPLOYERS:

#2 FORMER EMPLOYER, if applicable:
NAME & ADDRESS OF EMPLOYER

PLEASE INCLUDE DATES OF EMPLOYMENT, SALARY, POSITION, AND REASON FOR LEAVING:

#3 FORMER EMPLOYER, if applicable:
NAME & ADDRESS OF EMPLOYER

PLEASE INCLUDE DATES OF EMPLOYMENT, SALARY, POSITION, AND REASON FOR LEAVING:

#4 FORMER EMPLOYER, if applicable:
NAME & ADDRESS OF EMPLOYER

PLEASE INCLUDE DATES OF EMPLOYMENT, SALARY, POSITION, AND REASON FOR LEAVING:

AVAILABILITY:

We require at least two full weekdays of availability (Mon - Fri), as well as the availability to work weekends. A full weekday at these locations is work during the hours of:
7:15am - 8:00pm at the 39th Ave/I-75 location
7:15am - 6:00pm at the Main Street or Springhill location
7:15am - 6:30pm at the Newberry location

Please confirm this minimum requirement:

Yes, I understand the above expectation of availability, if offered a position with NAH.

These are the two weekdays that I can work FULL days, which means open to close.

Mondays

Wednesdays

Fridays

Tuesdays

Thursdays

In addition, on Mondays, I can also work part of the day during these hours (Example Between 2pm and 6pm)

In addition, on Tuesdays, I can also work part of the day during these hours (Example Between 2pm and 6pm):

In addition, on Wednesdays, I can also work part of the day during these hours (Example Between 2pm and 6pm)

In addition, on Thursdays, I can also work part of the day during these hours (Example: None, I cannot work on Thursdays)

In addition, on Fridays, I can also work part of the day during these hours (Example: Open to 1pm)

If we want to set up a phone interview after reviewing your resume/application, what days and time-ranges are best for you? (Here are some examples you might provide)

- Any Friday afternoon between 1 and 5pm
- Any weekday morning from 8am - Noon
- Evenings only after 6pm

Any employee may be required to undergo random testing for alcohol or drug abuse at any time during employment. Please acknowledge your understanding here:

Yes, I understand that I may be asked to drug-tested during my employment.

Would you like to upload a Resume and/or Cover letter?

Yes

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