Employment Application Docpopcorn Dippin Dots

Application for Employment

Docpopcorn Dippindots and National Laser Tag and Games and JURRASIC KARTS
Full Name*

First NameMiddle InitialLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
Choose your location prefrence:*

La Paza mall by JC pennyNAtional Laser tag and GamesHEB MissionJurassic kart MercedesAll of the aboveJurassic kart La Plaza mall
What position are you applying for?:(You may choose more than one)*

Sales AssociateShift leader (must have experience)Assistant ManagerManagerAll of the above
Are you planning to work as part- time (less than 36 hours per week) or full time ?*

parti timefull timeonly for the holidays or seasonalI dont know
Choose your employment status: ( if you do not know then you are usually a W2 worker*

W21099I dont know
Available start date:*

MonthDayYear
Are you authorized to work and remain in the United States?*

YesNo
Have you ever been convicted of any violation of the law? (Exclude traffic violations) A conviction will not necessarily disqualify an applicant from the position sought.*

YesNo
If Yes, Explain:
Do you have any outstanding warrants or criminak charges against you?*

YesNo
If Yes, Explain:
Have you ever been fired ?*

YesNo
If Yes, Explain:
Are there any physical limitations that will prevent you from carrying at least 50 lbs?*

YesNo
If Yes,Pls explain uour limitations:
Do you have reliable transportation to work*

YesNo
Do you have drive yourself or someone else drives you to work?*

I drive myselfNo
Are you related or know anyone currently working or have worked at Docpopcorn/Dippindots*

YesNo
Are you comfortable and willing to approaching customers to sample popcorn or ice cream?*

YesNo
We do not allow cell phone use for personal use, are you able to abide by this?*

YesNo

Availability, Check the shifts you are available

	AM	PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

What hourly rate do you expect to be paid?*
hourly rate requested
How much were you paid in your recent job?*
Pls explain and if you did not have a previous job say this is my first job
What would you do if a customer wanted to return something after the return period expired?*
Pls explain
What do you do if you can not make it to your scheduled work shift?*
What will you do if a see or witness a co-worker stealing money or mercahndise?*
If you are applying for a leadership or management position, explain why you are qualitifed to be manager or a leader.
Education:
Did you finish or earn a High School Diploma

YesNo
What year did you graduate High School?(if you are still in HS or did not finish HS, put N/A as an aswer)
Are you going to school right now?*

YesNo
Are in enrolled in college or vocational school?
type your answer
If you are in enrolled in college or vocational school, what are you studying?
type your answer
What is the highest level of education?*
Have you worked in the past?*

YesNothis is my first job
Can we contact your previous employer?*

YesNoNo because this is my first job
LIST BELOW WHERE YOU LAST WORKED

Beginning with your present or most recent experience, account for all employment during the past ten (10) years. To elaborate, asupplemental sheet or resume may be attached, but cannot be substituted for a completed application. Include military service ifapplicable.
Name of Employer:
Job Title:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Supervisor:
Date started

MonthDayYear
Date ended

MonthDayYear
Reason for Leaving:
Will they rehire you if you applied again for your old position?
Please answer Yes or No , please explain
Description of Duties:
Do you have additional employers to enter?

YesNo
Name of Employer:
Job Title:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Supervisor:
Date started

MonthDayYear
Date ended

MonthDayYear
Reason for Leaving:
Description of Duties:
Inquiry may be made of your current and former employers/schools you attended.
May we contact your present employer?

YesNo
May we contact your former employers?

YesNo
Personal References or Work reference
Full Name*

First NameLast Name
Relationships of reference
Phone Number

Area CodePhone Number
Upload Resume

Upload a File

Cancelof
Upload a Self Image
Take Photo of driver's license or school ID*
Take Photo of proof to work like socail security card or visa to work in the US
Should be Empty:

Application for Employment

Education:

LIST BELOW WHERE YOU LAST WORKED

Personal References or Work reference