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Rugby Surgery
3 Eastlands Court, St. Peters Road, Rugby, Warwickshire,
CV21 3QP
Tel: 01788 575300

Warwick Surgery
46 Coten End, Warwick, Warwickshire,
CV34 4NR
Tel: 01926 494923

Opening hours:
8.30am - 6.30pm Mon-Sat, Sun 10.00am - 4.00pm
Warwick surgery is not open Sundays.

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APPLICATION FORM FOR FULL TIME VETERINARY SURGEON

Where did you see the position advertised?		Vet Record This website Other..
Which Veterinary College(s) did you attend?
Qualifications i.e. BVetMedMRCVS
How many years have you been qualified?
Are you experienced in:
	Surgery	A little Moderately Very
	Small animal medicine	A little Moderately Very
	Equine	A little Moderately Very
	Wildlife	A little Moderately Very
	Lagamorphs	A little Moderately Very
	Opthalmology	A little Moderately Very
	Ultrasound	A little Moderately Very
	ECG	A little Moderately Very
	Radiography	A little Moderately Very
	Endoscopy	A little Moderately Very
	Oncology	A little Moderately Very
	Behaviour	A little Moderately Very

Do you have an area of special interest? i.e. orthopaedics
Are you a certificate holder?		Yes No
If so, which discipline?
Do you intend to pursue a certificate?		Yes No

Are you currently employed in a permanent position?
If so what notice period is required?
Do you have a full, clean drivers licence?		Yes No
Do you have any criminal convictions?		Yes No
Do you have any special needs? i.e. dyslexia		Yes No
If so please state:
Do you approve of blood sports?		Yes No
Do you have your own local accomodation?		Yes No
Do you have your own car?		Yes No
Are you a memeber of the T.A. or other organisation that necessitates unpaid leave?		Yes No
Are you used to working as part of a team?		Yes No
How would you descibe your communication skills?		Excellent Good Average Poor
Which areas of CPD interest you?
Are you a member of any charities i.e. WSPA, RSPCA etc.		Yes No
Are you keen to help fund-raise for charities?		Yes No

Title:
Full name:
Address:
Postcode:
Tel No:
Email Address:
Please list any comments or details about yourself that help support your application:

Thank you for completing this form.

This helps us to know some details quicker than receiving your c.v. there are no wrong answers to any of these questions, they are designed to help us see a little of your character and competencies. We will respond to any application within 48 hrs. All submissions are treated as strictly confidential and not passed to any third parties.

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