Application Form For Employment Page 2
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1
2LYNN DAIRY QUEENS, INC.
EXPERIENCE
List below all present and past employment, beginning with your most recent employer.
List below all present and past employment, beginning with your most recent employer.
1. Employer_______________________________________________ Starting Salary _______________per
1. Employer
per
per
per
per
per
per
Hour
Hour
Hour
Hour
Hour
Hour
Hour
Week
Week
Week
Week
Week
Week
Week
Year
Year
Year
Year
Year
Year
Year
Dates Employed ________________to ______________________ Last Salary __________________per
Dates Employed
per
per
per
per
per
per
Hour
Hour
Hour
Hour
Hour
Hour
Hour
Week
Week
Week
Week
Week
Week
Week
Year
Year
Year
Year
Year
Year
Year
Address________________________________________________ Supervisor __________________________________________________________
Address
Street
City
Job Title _______________________________________________
Job Title
Reason for leaving ____________________________________________________________________________________________________________
Reason for leaving
For Job Reference, call __________________________________ Telephone # ( __________
For Job Reference, call
Telephone # ( __________
Telephone # (
__________)
__________ _____________________________________________
)
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
No
No
No
No
No
No
No
No
2. Employer_______________________________________________ Starting Salary _______________per
2. Employer
per
per
per
per
per
per
Hour
Hour
Hour
Hour
Hour
Hour
Hour
Week
Week
Week
Week
Week
Week
Week
Year
Year
Year
Year
Year
Year
Year
Dates Employed ________________to ______________________ Last Salary __________________per
Dates Employed
per
per
per
per
per
per
Hour
Hour
Hour
Hour
Hour
Hour
Hour
Week
Week
Week
Week
Week
Week
Week
Year
Year
Year
Year
Year
Year
Year
Address________________________________________________ Supervisor __________________________________________________________
Address
Street
City
Job Title _______________________________________________
Job Title
Reason for leaving ____________________________________________________________________________________________________________
Reason for leaving
For Job Reference, call __________________________________ Telephone # ( __________
For Job Reference, call
Telephone # ( __________
Telephone # (
__________)
__________ _____________________________________________
)
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
May we contact this employer?
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, immediately
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
Yes, at a later date
No
No
No
No
No
No
No
No
If you need more space to list additional work history, please write on the back of this page.
If you need more space to list additional work history, please write on the back of this page.
ACTIVITIES
List any additional activities or community service programs in which you participate that may be relevant to your candidacy
List any additional activities or community service programs in which you participate that may be relevant to your candidacy
I understand that this application for employment is for a job with an independently owned and operated franchise of the
Dairy Queen
system. I also understand that misstatements or omissions of information in connection with my application
®
for employment can lead to rejection of my application or dismissal from employment, whenever discovered. I authorize
this company 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 this company and myself for either employment or for 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
unless expressly made in a formal written contract of employment signed by me and an authorized representative of this
company.
I hereby attest that all statements made by me above are true to the best of my knowledge.
Date ____________________
Applicant’s Signature ______________________________
[T:\HRD082.INDD]
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