DQ Application Web

Springfield Dairy Queen Employment
Application

An Equal Opportunity Employer

Full Name*

First NameLast Name

Preferred name if different from above

Preferred name

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Birth Date*

MonthDayYear

Last 4 digits of social security number*

Phone Number*

Area CodePhone Number

Have you ever worked for DQ?*

YesNo

If yes, where?

I am available to begin working...*

ImmediatelyAt a later date (please specify below)

Do you have reliable transportation to get you to and from work?*

YesNoUnsure at this time

Referred by*

If referred by employee, please list name(s)

Position applying for*

Have you previously applied for work at this DQ location*

YesNo

If yes, when?

Check each day you are available to work (please note that most positions require weekend availability)*

Type of employment desired (check all that apply)*

Full-timePart-timeTemporarySummer only (unable to work beyond August)

Are you willing to work (check all that apply)*

Days (11a-5p)Evenings (5p-11p)After School (3p-6p)Holidays

Salary acceptable per hour*

If still attending school, are you willing to work at least 2 school nights a week?*

YesNoUnsure at this timeN/A

Total hours available per week?*

Please list any dates/times that you cannot work due to vacation, activities, etc.

Work History: Current and previous 2 employers (most current employer listed first)

Name of Present Employer

City, State

Position Held

Start Date

MonthDayYear

Employer Phone Number

Area CodePhone Number

Supervisor Name

First NameLast Name

Starting Salary

Ending Salary

Describe your duties:

May we contact this employer?

Yes, immediatelyYes, at a later dateNo, do not contact

Reason(s) for leaving

Name of Previous Employer

City, State

Position Held

Start Date

MonthDayYear

End Date

MonthDayYear

Employer Phone Number

Area CodePhone Number

Supervisor Name

First NameLast Name

Starting Salary

Ending Salary

Describe your duties:

May we contact this employer?

Yes, immediatelyYes, at a later dateNo, do not contact

Reason for leaving

Name of Previous Employer

City, State

Position Held

Start Date

MonthDayYear

End Date

MonthDayYear

Employer Phone Number

Area CodePhone Number

Supervisor Name

First NameLast Name

Starting Salary

Ending Salary

Describe your duties:

May we contact this employer?

Yes, immediatelyYes, at a later dateNo, do not contact

Reason for leaving

Hobbies and Recreational Interests

Class Organizations, Scholastic Honors, and other school activities (At your option, you may exclude organizations which indicate race, age, sex, creed, color, national origin, religion, or other protected class.)

Have you ever been convicted of a felony? (This info may be considered in hiring or job placement, but will not automatically disqualify you from employment) *

YesNo

If yes, please give date and explain

HIGH SCHOOL

Name & City/State of High School*

GPA*

Highest Grade Completed*

9101112

Did you graduate?*

YesNoStill attending

COLLEGE OR UNIVERSITY

Name & City/State of College or University

Course of Study/ Degree Earned

GPA

Did you graduate?

YesNoStill attending

OTHER

Name & City/State of OTHER (specify)

Course of Study/ Degree Earned

GPA

Did you graduate?

YesNoStill attending

Why do you wish to work at Dairy Queen?*

Why would our store want you on our team?*

Upload Resume (required for management positions)

Upload a File

By Signing below, I authorize the store owner to investigate all statements made by me on this application form. I understand that misstatements or omissions of information in connection with my application for employment can lead to rejection of my applications or dismissal from employment, whenever discovered. I also authorize the store owner to request and receive references from my former employers and I hereby release those employers supplying any information from liability.

I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the store owner and myself for either employment or the providing of any benefits. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the store owner unless expressly made in a formal written contract of employment signed by me and an authorized representative of the store owner. If I am hired, I understand that my employment would be "at will," which means that I would have the right to terminate my employment at any time for any reason and that the store owner would have the same right. I hereby attest that all statements made by me above are true to the best of my knowledge.

Signature*

GENERAL INFORMATION

JOB INTEREST

Employment History Information

Additional Information

EDUCATION INFORMATION