Pet Nanny | Employment Application Form Pet-Nanny

Name*

Social Security No.

Address*

City

State

Home Phone*

Cell Phone*

Email address*

Are you 21 years or older?

Yes
No

Are you authorized to work in the US?

Yes
No

Have you been convicted of a Felony or Misdemeanor?

Yes
No

What hours are you available?

Are you available weekends?

Yes
No

Are you available holidays?

Yes
No

Are available to make rounds within a 5-10 mile radius of your home?

Yes
No

Are there any areas in which you would like to pet sit?

Yes
No

Preference

Date available for work

Do you presently have any pets of your own?

Yes
No

Type

Years owned

Describe any past work experience with pets

Are there any pets for which you would refuse to care?

Yes
No

Pets you would refuse to care

In your own words, why would you like to be a pet sitter?*

Do you have reliable transportation?

Yes
No

Make/Year of Vehicle

Name of automobile insurance provider

Policy #

Own Computer and are you online?

Yes
No

Own Printer?

Yes
No

Own Cell Phone?

Yes
No

Do you have a valid driver license?

Yes
No

State and License No.

Are you honest, reliable and trustworthy?

Yes
No

Please provide four (4) references (not relatives) that we may contact who have known you for several years and can attest to your good character. Please provide an accurate andcomplete mailing address for each.

References

Name	Address	City/State/Zip	Phone	Occupation	Years

Education

Diploma/Major Subject

High School

Business School

Trade School/Technical College

College/University

PETSITTER ESSENTIAL FUNCTIONS Check all that apply

Can you do these essential functions?

Yes
No

Please explain any you are unable to do

Work Experience

List below last four employers starting with last one first

Employers

From-To	Company	Address	Position	Wage/Salary	Reason for leaving	Supervisor	Phone

APPLICATION CERTIFICATION

I certify that all of the statements made in this application are true and correct to the best of my knowledge and belief and are made in good faith. I give you and your agents the right to investigate all information given and to secure additional information, if necessary including a criminal background check. I hereby release from all liability or responsibility all persons, companies, corporations furnishing such information.

You will be considered an Independent Contractor and be responsible for your own taxes.

All Pet Nanny Clients belong to Pet Nanny. You are to use Pet Nanny Material only for Pet Nanny Clients, not for personal use. Pet Nanny clients are not for your personal use (in any form) and will be subject to legal action and a finder’s fee of $5,000 for each client. Client will be subject to legal action as well.

Name as Signature (required)*

Name*

Date*

CAPTCHA