AJ’s Market & Ice Cream at Southtowne

140 S. Jefferson Street, Pensacola, Florida 32502

850-466-6841

EMPLOYMENT / JOB APPLICATION

Personal Information

Full Name

Date

Address

Zip Code

Email

Phone

Date Available

Desired Pay

Position Applied For

Employment Desired
Full TimePart TimeSeasonal

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Employment Eligibility

Are you a U.S. Citizen?
YesNo

Allowed to work in U.S.?
YesNo

Work Authorization Dates

Felony Conviction?
YesNo

If Yes, Explain

Able to lift 50 lbs?
YesNo

Able to scoop Ice Cream?
YesNo

Can count change?
YesNo

Food handler license?
YesNo

Unavailable Days/Times

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Employment History (Employer 1)

Employer Name

Email

Phone

Address

Zip

Job Title

Responsibilities

Hourly Pay

Start Date

End Date

Reason for Leaving

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Employment History (Employer 2)

Employer Name

Email

Phone

Address

Zip

Job Title

Responsibilities

Hourly Pay

Start Date

End Date

Reason for Leaving

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Employment History (Employer 3)

Employer Name

Email

Phone

Address

Zip

Job Title

Responsibilities

Hourly Pay

Start Date

End Date

Reason for Leaving

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Education

High School

City/State

From

To

Graduated
YesNo

College

City/State

From

To

Graduated
YesNo

Degree

Other

City/State

From

To

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References

Reference 1 Name

Relationship

Company

Title

Email

Telephone

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Reference 2

Reference 2 Name

Relationship

Company

Title

Email

Telephone

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Background Check

Consent for background check
YesNo

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Disclaimer

APPLICATION UNDERSTANDS THAT THIS IS AN Equal Opportunity Employer and committed to excellence through diversity. In order to ensure this application is acceptable, please print or type with the application being fully completed in order for it to be considered.

I, the Applicant, verify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.

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Signature

Type your full name as signature

Date