EMPLOYEE APPLICATION

Name *

First

Last

Year-Round Address *

Address Line 1

Address Line 2

City

State

Zip Code

Summer Address (if different from year-round address)

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone *

Cell Phone Carrier *

Needed if Hired

Email *

Birth Date *

Ever worked in an ice cream shop before? *

If yes, when and where?

AVAILABILITY

Desired Position *

Total Hours Available per Week *

Are you SERVSAFE Manager Certified? *

Are you legally able to be employed in the U.S.? *

Are you available to work thru October? *

Would you be able, and willing, to pick up shifts unexpectedly? *

Do you play a sport or participate in a regular activity? *

How did you hear of the job? *

How far do you live from the shop in the summer? *

Do you have reliable transportation to work? *

School Most Recently Attended

School Name *

City & State *

Phone *

Teacher Reference *

Last Grade Completed *

Grade Point Average *

Two Most Recent Jobs

If a job is not applicable, list U.S. military service, work performed on a voluntary basis or personal references.

Company 1

Company 1 *

Location *

Phone *

Job Position *

Supervisor *

First and Last Name

Dates Worked *

FROM ____ TO ____

Salary *

Reason For Leaving

If applicable.

Company 2

Company 2 *

Location *

Phone *

Job Position *

Dates Worked *

FROM ____ TO ____

Supervisor *

First and Last Name

Salary *

Reason For Leaving

If applicable.

Physical

Any health problems or physical disabilities which could affect your employment? *

Please explain a 'Yes' answer in detail.

Do you now have, or have you had, within the last 6 months, any contagious or communicable diseases, or gastro-intestinal infections, hepatitis or salmonella? *

During the past 7 years, have you ever been convicted of a crime, including misdemeanors and traffic violations? *

*a conviction will not necessarily bar you from employment.

If yes, please describe in full in the space provided.

1. I certify that the information on this application is correct to the best of my knowledge and understand that deliberate falsification is grounds for dismissal in accordance with the policies of KGGK, Inc d/b/a Katie’s Homemade Ice Cream. 2. I authorize the references listed above to give you any, and all, information concerning my previous employment and pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. 3. I acknowledge that, if I become employed, I will be free to terminate my employment at any time for any reason and that KGGK Inc d/b/a Katie’s Homemade Ice Cream retains the same rights. No representative of KGGK Inc. d/b/a Katie’s Homemade Ice Cream has the authority to make any contrary agreement. *

I agree.

KGGK Inc. d/b/a Katie’s Homemade Ice Cream is an equal opportunity employer. The Civil Rights Act of 1964 and State and Local laws prohibit discrimination on the basis of race, color, religion, sex, national origin or veteran status.

EMPLOYEE APPLICATION

AVAILABILITY

School Most Recently Attended

Two Most Recent Jobs

Company 1

Company 2

Physical

YOUR APPLICATION WILL BE CONSIDERED FOR 30 DAYS- FOR CONSIDERATION AFTER THAT YOU MUST REAPPLY. THIS SCOOP SHOP IN LOCALLY OWNED AND OPERATED.