Smith Dairy Queens, Ltd.

EMPLOYMENT APPLICATION

DQ - That's What Like about Texas

INSTRUCTIONS:

This application is intended for use in evaluating your qualifications for employment.

Please answer all questions completely and accurately.

All applicants will receive consideration without discrimination based on sex, marital status, race, color, age, creed, national original, sexual orientation, military reserve membership, ancestry, religion, height, weight, uses of guide or support animal because of blindness, deafness or physical handicap or the presence of disabilities.

LOCATION PREFERENCE:

1st Choice

2nd Choice

3rd Choice

POSITION APPLYING FOR:

General Manager
Assistant Manager
Shift Leader
Grill Staff
Chill Staff
PERSONAL HISTORY

Name (Last)
(First)
(Middle)

Address
City
State
Zip


Phone Number

E-Mail Address

Social Security Number



Are you over 18 years of age or older?
Yes
No
If not, what is your birth date? (mm/dd/yyyy)


Have you worked at Smith Dairy Queens, Ltd. before?
Yes
No
If yes, Where?
When? (mm/dd/yyyy)


How did you learn about us?
Snag-a-Job
CareerBuilder
Monster
Newspaper
Friend
Walk-In
Relative
Other


Can you perform the essential functions for which you are applying?
Yes
No
If no, please describe


Are you legally eligible for employment in the United States?
Yes
No
Proof of citizenship or immigration status will be required within 3 days of hire.


Have you ever been convicted of a felony or misdemeanor?
Yes
No
City/State
Charge


Please explain


Date you can start:

Availability: Full Time
Part Time
Shift Work
Temporary

Are you willing to work weekends?
Yes
No

Are you willing to work Holidays?
Yes
No

Do you have a way to get to and from work?
Yes
No

What shifts are you available for?
Days
Evenings
Nights