Electronic Job Application

Dear Potential Applicant:

Thank you for your interest in applying for a position with Mike’s Ice Cream. Please fill out the application completely to the best of your ability. When you have completed the application, please return it to the business address shown at the top of the application.

All applications will be kept on file for one year, and will be considered anytime there is a position available. Thank you once again for your interest.

Sincerely,

Michael Duguay
Owner, Mike’s Ice Cream

Your Name

Address

City

State

Phone

Email

Do you have the legal right to work in the United States?
 yes no
Location Applying For?

EMPLOYMENT HISTORY (list most recent first)
Employer Company Name

Address

Position Held

Start Date (month/year)

End Date (month/year)

Supervisor Contact Name & Number

Reason for Leaving

Employer Company Name

Address

Position Held

Start Date (month/year)

End Date (month/year)

Supervisor Contact Name & Number

Reason for Leaving

Employer Company Name

Address

Position Held

Start Date (month/year)

End Date (month/year)

Supervisor Contact Name & Number

Reason for Leaving

EDUCATION
School Name & Location

Highest Degree or Grade Completed

Month & Year Completed

School Name & Location

Highest Degree or Grade Completed

Month & Year Completed

PERSONAL REFERENCES
Name

Address

Phone Number

Relationship to Applicant

Name

Address

Phone Number

Relationship to Applicant

Have you ever been convicted of any felonies?
 yes  no
If so, please describe

Any misdemeanors other than traffic violations?
 yes no
If so, please describe

Are there any charges currently pending against you?
 yes no
If so, please describe

What skills or strengths do you have that would make you a good employee?

WORK LIMITATIONS/PREFERENCES

Please list hours which you are able to work between 7am and 12midnight seven days a week (how flexible are you?)
Monday: (example: 7-3pm, or none)
Tuesday:
Wednesday:
Thurday:
Friday:
Saturday:
Sunday:

List any day or hour preferences

Approximately how many hours per week would you like to work?

Would you like to work year round or seasonally?

If you check year round above, and only a seasonal position is available, would you still like to be considered for that seasonal position?

Do you have any physical limitations which would prevent you from doing strenuous work or moderately heavy lifting? If yes, please describe.

How did you hear about this position?

I would like to attach a cover letter or resume

I certify that all above answers are true and accurate to the best of my knowledge. (Typing your name in box will work as your signature)

Mike’s Ice Cream does not discriminate against applicants or employees on the basis of race, religion, color, veteran status, sex, age, height, weight, national origin, marital status, sexual orientation, pregnancy, handicapping condition or disability.