Order Number Thank you for your interest in our Veterinary Assistant program. Before completing this form please ensure you have the following information available: a copy of your high school diploma and a copy of your resume. Fields marked with an asterisk (*) must be filled out before submitting. Personal Identification First Name * Last Name * Address * City * Province * Postal Code * E-mail Address * Phone Number * Birthdate * DD/MM/YYYY Diversity Self Identification You may self-identify in more than one category. You may decline to answer any or all of the questions in this section. Do you consider yourself to be an Indigenous/Aboriginal person? Yes No Do you consider yourself to be a racialized person? Yes No Do you consider yourself a person with a disability? Yes No To which gender do you most identify with? Female Male Transgender Female Transgender Male Gender Variant/Non-conforming Not Listed Prefer Not To Answer Behavioural Expectations Please select your level of agreement with the following statements. I have the ability to stand for long periods of time. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I have the physical capacity to kneel down and crouch down in numerous yoga-like positions to conform to the size of the patient being are worked on. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I am willing to accept the requirement to clean up urine, feces, blood, hair and vomit on a daily basis. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I am willing to work weekends, nights, holidays, long hours and be on call. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I have the physical capacity to lift to lift 40-50 pounds. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I have the ability to remain calm under stressful conditions. For example, upset owners, aggressive or uncooperative animals, euthanasia, and seeing severe injuries caused by trauma or neglect. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I have resiliency and I use a variety of self care techniques and strategies to manage stressful situations. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I get a good night’s sleep, eat well and work to stay healthy. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I am able to work in a noisy environment. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I am able to multi task. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I enjoy providing high quality customer service. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I am detail orientated. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree I am a strong communicator. * (1) Strongly disagree (2) Disagree (3) Neither agree nor disagree (4) Agree (5) Strongly agree Education and Experience I have volunteered at an animal shelter, hospital or refuge. * Yes No Other If other, please describe. I have graduated from high school or equivalent. * Yes No Please input your top three classes in Grade 11 and 12. For example, Woodworking 78%, English 68%, Physical Education 82%. Grade 11 (%) Course Name & Percentage Course Name & Percentage Course Name & Percentage Grade 12 (%) Course Name & Percentage Course Name & Percentage Course Name & Percentage Please add additional comments to describe why you are a strong applicant for this program. Referral How did you hear about this opportunity? I was referred by: Additional Questionnaire As part of our process we ask that you complete the following behavioural and cognitive questionnaires by following the link below. Once the behavioural is complete the cognitive will follow in a separate email. We use this information to improve our educational programs and help us build strong teams. This will open in a new tab so you can complete the questionnaires and return back to your original tab here to complete your application. Click Here Understanding and Consent Consent * I hereby verify that all information provided in this form is truthful and correct. If successfully selected for the next stage, I will complete an interview with the program director.