Employment – Scoops

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Email your employment form to: scoopssugarhill@gmail.com

Applicant Information

Full Name *: Date:

Address:

Phone *:E-mail Address:

Are you a citizen of the United States?YesNoIf no, are you authorized to work in the U.S.?YesNo

Have you ever been convicted of a felony?YesNo If yes, please explain:

Employment Desired

Position:

Desired Salary:

Date Available From:

Have you ever applied to the Scoops before?:YesNo

If so, when?:

Would you accept another position?:YesNo

If so, which one?:

How did you hear about us?:

Education

High School:

Address:

From:

To:

Did you graduate?:YesNo

College:

Address:

From:

To:

Did you graduate?:YesNo

Degree:

Other:

Address:

From:

To:

Did you graduate?:YesNo

Degree:

References

Please list three persons not related to you, whom you have known at least one year.

S.No.	Name	Address & Phone Number	College/Business	Years Acquainted / How do you know this person?
1
2
3

EMERGENCY CONTACT NAME: PHONE#

Share a couple of sentences why you want to work at Scoops and what special abilities make you a good candidate for employment.

Previous Employment

Please list current and/or previous employers, starting with the most recent one first. Please include any experience which is related to the job for which you are applying. Please complete even if you attach a resume.

Company 1:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference? :YesNo

Company 2:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference? :YesNo

Company 3:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference? :YesNo

Disclaimer and Signature

I hereby authorize Scoops to thoroughly investigate my background, references, employment record and other matters related to the suitability for employment. I authorize persons, schools, my current employer (if applicable), and previous employers and organizations contacted by Scoops to provide any relevant information regarding my current and/or previous employment and I release all persons, schools, employers of any and all claims for providing such information. I understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up to and including dismissal. I understand that I may be required to sign a confidentiality and/or non-compete agreement, should I become an employee of Scoops. I understand that nothing contained in this application, or conveyed during an interview which may be granted, is intended to create an employment contract. I understand that filling out this form does not indicate there is a position open and does not obligate Scoops to hire me.

I UNDERSTAND THE POSITION FOR WHICH I AM APPLYING WILL PROBABLY INVOLVE NIGHT AND WEEKEND SHIFTS. I CERTIFY THAT I AM WILLING AND ABLE TO WORK THESE SHIFTS.