Fillable First Last State Street Address City Zip Code

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First Last State Street Address City Zip Code

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Full Name:
Address:
Phone:
Email:
Time of Day
Available:
Comments:
Where did you hear about the job posting?
First Last
Date:
Street Address City
State
Zip Code
(Home) (Cell)
High School:
Cummulative
GPA
Year Graduated or
Est. Graduation
Year Graduated or
Est. Graduation
Cummulative
GPA
College:
If you are more than 4 years out from your most recent graduation date then please include
your resume instead.
Mon
(Indicate Range/Day)
Start + End
Tue
Start + End
Wed
Start + End
Thur
Start + End
Fri
Start + End
Sat
Start + End
Sun
Start + End
Please be able to turn in a copy of your most recent school transcript upon request (unofficial is fine)
Sports and
Extracurricular
Activities:
Previous Employment History:
Employer: Dates of Employment:
Supervisor: Phone No.
Address/Location:
Job Title & Responsibilities:
Reason for Leaving
May we contact this employer? Yes No (please check one)
Employer: Dates of Employment:
Supervisor: Phone No.
Address/Location:
Job Title & Responsibilities:
Reason for Leaving
May we contact this employer? Yes No (please check one)
Name: Relationship:
Address:
References: (Should be character references other than former employers such as teacher, coach, volunteer coordinator, pastor, etc.)
Phone: (Home) (Cell)
E-mail:
Street Address City State Zip Code
Name: Relationship:
Address:
Phone: (Home) (Cell)
E-mail:
Street Address City State Zip Code
Notification, Authorization and Certification:
I am hereby notified that certain diseases such as Hepatitis A, E Coli 0157, Salmonella, Shigella,
Staphylococcus, Giardia, Streptococcus and Campylobacter will prevent me from handling food
equipment until a clean bill of health is received from my medical doctor. It is my obligation to
Pelican’s SnoBalls to immediately notify my supervisor should I knowingly become or believe
that I am infected with any of these diseases.
I hereby authorize the former employers and references I have listed on this application to provide
to Pelican’s SnoBalls with any information that would be meaningful and relevant to this
employment application and I release all parties from all liabilities and/or damages that result from
furnishing such information. I certify that I have fully read and have accurately completed this
employment application to the best of my knowledge. I acknowledge that any false information
contained in this employment application may be grounds for Pelican’s SnoBalls to disregard my
employment application or to terminate my employment upon discovery of such false information.
I agree to read and follow the rules and regulations contained in the Pelican’s SnoBalls Employees
Handbook that will be provided to me upon my employment and which may be updated
periodically by Pelican’s SnoBalls. I understand that Pelican’s SnoBalls is an at-will employer and
that
Pel
ica
n’s SnoBalls may terminate my employment at any time for any reason, with or without
cause and that I also have these same rights with regard to terminating my own employment.
I understand that Pelican’s SnoBalls is an equal opportunity employer and that Pelican’s SnoBalls
makes every effort to comply with various federal, state and local employment laws, as applicable.
I also understand that the information I have provided in this application will not be used for any
purposes(s) that are prohibited by law.
Signature_______________________________________ Date___________________
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First Last State Street Address City Zip Code

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Completed 10 July 2022

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