Pet Pickup

All fields are required to be filled out. If they are left blank, your application may not be able to be processed.

Personal Information Section:

Have you ever applied at/worked at PetPickup before?	YES NO
Have you ever worked for a dog waste removal service company before?	YES NO
How were you referred to Pet Pickup?

First Name:
Last Name:
Address:
City:
State:
Zip:
Nearest Main Road Intersections of your Current Residence:

Cell Phone #:
Alternate Phone #:
Email:
Date of Birth:
Height:
Weight:
High School:
Graduated?
Year:
College:
Graduated?
Year:

Are there or have there ever been any medical concerns with your general health, back, joints, muscles or are you currently taking any prescribed medications?	YES NO
Have you been injured, hospitalized or had surgery within the last two years?	YES NO
Are you or have you ever been on Probation or Parole?	YES NO
Do you have a working computer, printer and broadband internet connection at your home?	YES NO
Type of Position Desired:
Desired frequency of work:
Available Start Date:
Are you currently employed?	YES NO
If you answered yes to the previous question, what days do you work?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Days available to work for Pet Pickup, Inc:
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
We only work "daylight hours". What times of the day(s) are you available outside of your current work / school schedule:

Vehicle Information Section:

Vehicle Year:
Vehicle Make:
Vehicle Model:
Vehicle Color:
Engine:
Mileage:
4 Wheel Drive/All Wheel Drive?		YES NO
*Please Describe the Condition of your Vehicle :**

Are you willing to drive distances (40-140 miles per day)?	YES NO
Do you have a "Smartphone"?	YES NO
Do you have a separate GPS (not on your phone)?	YES NO
Number of Points on Driving Record:
Are you willing to obtain a copy of your driving record?	YES NO
Auto Insurance Provider:
Have you had insurance for more than 30 days?	YES NO

By checking this box, you understand and take into consideration that the nature of this type of work is a rather humble position. If your ego or pride makes you feel as if you are above picking up pet waste, please do not apply.
If you have a resume you'd like to submit, please feel free to upload it below: Please upload pictures of the vehicle you will be using(all four sides). You can also include pictures of yourself.
*Only choose one file per upload button.

Authorization:

"I certify that the facts contained in this application are complete to the best of my knowledge and understand that, if hired, falsified statements on this contractor application shall be grounds for termination.

I authorize investigation of all statements contained herein the company/contractor references and employers listed on my resume to give any and all information concerning my previous employment/contractual work and any pertinent information they may have, personal or otherwise, and release the company of all liability for any damage that may result from utlization of such information.

This waiver does not permit the release or use of disability related medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

By entering my full name in the box below as an electronic signature, I hereby certify that the information entered above is correct to the best of my knowledge, and that falsifying information shall be grounds for disqualification from or termination of employment."

Please verify that all of the fields above are filled out. If they are left blank, your application may not be able to be processed.

Work Opportunities

Personal Information Section:

Vehicle Information Section:

Authorization: