Independent Contractor Pet

							            WatchDogs                          Independent Contractor Application
           P.O. Box 664-Evanston, Il 60204-0664 847 877 3004 info@watchdoggies.com
  WatchDogs policy prohibits discrimination on the basis of color, disability, marital status, age, national origin, race, religion, sex,
                      sexual orientation or any other characteristic protected by federal, state or local laws
Name and Address
Name (Last, First)                                                     Social Securit y Number
Address                                                                Home Phone
                                                                       Business Phone
                                                                       Cell Phone
                                                                       Email Address


Position Desired
Expected Pay (per dog walk or cat visit):     Have you worked for WatchDogs before?             What date are you available to start?
                                              If yes, when?

Do you have pet care/dog walking experience with a professional        Do you have veterinary technician experience?
company? If yes, where?


What hours are you available to work? Please be specific:

               Monday          T uesday        Wednesday          Thursday           Friday        Saturday        Sunday
From/To
Overnight
Care 9pm-
8am

We hope that independent contractors are available two major ho lidays per year. Are you available for two
major holidays per year? If yes, which t wo?

Employment Status
Are you currently employed? If yes, please     Is it your intent to continue in your current     During the past 5 years, how many
note if you are employed full-time or part-    job(s) if you work here?                          different employers have you worked for?
time.



Please list the last three places of employ ment. Please include all in formation, including phone numbers
and names of supervisors.
Name of          Complete              Name of                Ending         Job              Reason for Leaving            Start       Ending
Business         Address of            Supervisor             Salary         Title                                           Date       Date
                 Business




Education (Please list highest level of education)
Name of School                     Address                             Curriculum or Major                    Did you graduate?
Other Information
Are you legally eligible to        Have you ever been convicted       Are you over 21 years of age?     How did you find out about
work in the United States?         of a crime or violation other                                        employment with WatchDogs?
                                   than a minor traffic violation?
Document number and
expiration date (if applicable):
                                   If yes, list all convictions,
                                   stating date, nature of offenses
                                   and where they occurred.



Do you have any current or pre-existing medical conditions that would prohibit you from fulfilling the job requirements (e.g. a strong
dog pulling would aggravate a knee injury)?

If yes, please state:


Emergency Contact
Name                                          Address                                       Phone

What is your relationship to this person?



Personal References
Please list three personal references that you have known for a minimu m of t wo years

Name                                          Phone                                          Relationship (length of)




Have you ever owned a pet/s? If so, what kind of pet/s and what was his or her name/s?




Why do you think you would make a good asset to our company?




Acknowledgements and Agreements
I authorize WatchDogs and its agents to request, obtain, and use consumer reports, including without limitation, investigative
consumer reports, now and at any time, to evaluate hiring, promoting, reassigning, transferring, retaining or discharging me.
I acknowledge that in connection with my application for employment, promotion or reassignment with WatchDogs, an
investigative consumer report or other inquiry may be made as to my character, general reputation, personal characteristics
and mode of living. If a report is made, I have been advised further that upon written request, within a reasonable time,
additional information as to the nature and scope of the report, if one is made, will be provided.
I understand that if I am employed, employment is not for a stated period. Either WatchDogs or I may discontinue the
employment relationship at any time. In this case notice will be made.
I ce rtify that all statements and answers made on this application are complete and true. I understand that if subsequent to
employment any of such statements and/or answers are found to be false or that information is omitted, such false statements
or omissions will be considered grounds for termination of my employment.


Applicant Signature __________________________________________ Date___________________ ___