Full Name*

Street Address*

City*

State*

Zip Code*

Telephone*

E-mail Address*

Have you ever worked for YOGURT STOP before?*

No Yes

Are you 18 years of age or over (proof of age or work permit may be required)?*

No Yes

If not 18 years old, birthdate?

Are you legally able to be employed in this country (if hired, verification will be required by law)?*

No Yes

Have you been convicted or pleaded guilty to a crime in the past 7 years?*

No Yes

If yes, please explain:

Are you willing to take a drug test?*

No Yes

What type of position are you seeking?

Part-Time Full-Time Seasonal Temporary

Total hours available per week?

Date available to start?

We are open Sundays during the summer. Are you able to work Sundays?*

Please list days and times not available to work:

Education Level

in High School High School Diploma in College College Graduate

High school name, city, state, dates attended?

College name, city, state, dates attended, major/minor?

Please list other relevant skills, specialized training and activities:

Most recent employer company name, address, city, state?

Job Title

Supervisor's name and phone number?

Date Started

Date Left

Salary/Wage Start

Salary/Wage End

Reason for leaving?

May we contact this employer?

No Yes

Second most recent employer company name, address, city, state?

Job Title

Supervisor's name and phone number?

Date Started

Date Left

Salary/Wage Start

Salary/Wage End

Reason for leaving?

May we contact this employer?

No Yes

First reference's name, phone number, relationship, years known:

Second reference's name, phone number, relationship, years known:

Please list any other additional information you would like to provide:

I agree that the information that I have provided above is true and correct to the best of my knowledge.*

(check here)

Signature (type name):*

Security Text*

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Employee Application