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?
    yesno
    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?
    yesno
    If so, please describe

    Any misdemeanors other than traffic violations?
    yesno
    If so, please describe

    Are there any charges currently pending against you?
    yesno
    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: 3pm-12am, OPEN 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.