Join us at Dairy Star this summer Personal InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Are you 18 years or older?*YESNODate of birth* Date Format: MM slash DD slash YYYY Are you a US citizen, or an alien authorized to work in the US?*YESNOIn case of emergency, please notify:* First Last Emergency Contact Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Emergency Contact Phone*AvailabilityHow many hours per week are you seeking?*Date you can start?* Date Format: MM slash DD slash YYYY What days and times are you available to work?*DayStartEnd Do you have reliable transportation to and from work?*YESNOAny other limitations?i.e. summer school, religous services, etcPersonal GoalsWhat accomplishments are you most proud of?*What are your 5-year goals?*What is your greatest talent?*EducationSchools Attended*School Name# of years attendedSubjects studiedGraduation Date Elementary, High School, CollegeFormer EmploymentList your last four employers, starting with the most recent*DateName and addressSalaryPositionReason for Leaving ReferencesList names of three persons not related to you, whom you have known at least one year.*NamePhoneBusinessYears Known Special Skills or QualificationsSummarize any special skills or qualifications you have:*I certify that my answers are true and complete to the best of my knowledge. I authorize Dairy Star to make such investigations of my personal, employment, educational, financial and other related matters as may be necessary for an emplyment decision. I hereby release employers, schools or individuals from all liability responding to inquiries in connection with my application. In the event I am employed, I understand that false or misleading information given in my application or interview(s) may reult in discharge. Signature*Date Date Format: MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.
