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Contact Information
Name
*
First
Last
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Address
*
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Date Format: MM slash DD slash YYYY
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*
Yes
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Names of friends or relatives employed in this organization
Have you ever applied to Pops and Rockets before?
*
Yes
No
Have you been employed by Pops and Rockets before?
*
Yes
No
Do you have any family, business, health, or social restrictions or obligations that would prevent you from performing the job responsibilities?
*
Yes
No
Do you have any physical or mental condition or handicap which would endanger the health or safety of yourself and or others or that may affect your ability to perform the job(s) for which you are applying?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
Will you comply with the safety work and attendance policies of our organization?
*
Yes
No
Position, Schedule and Availability
Position(s) Desired or Area of Interest:
*
Retail position in shop.
Making Pops and Ice Cream
Working Events
Making Deliveries
Desired hours.
*
Part-time
Full-Time
Second Job (if you are already working)
Temporary
Shifts you can work:
*
Tuesday 11:30am - 3pm
Tuesday 2:30pm - 9:30pm
Wednesday 11:30am - 3pm
Wednesday 2:30pm - 9:30pm
Thursday 11:30am - 3pm
Thursday 2:30pm - 9:30pm
Friday 11:30am - 3pm
Friday 3pm - 10:30pm
Saturday 11:30am - 3pm
Saturday 3pm - 10:30pm
Sunday 11:30am to 6:30pm
Any Weekday
Any weekend day
Please check all the times that you are available to work.
How will you get to work?
*
How were you referred to Pops and Rockets?
*
Social Media
Friend or Family Member
Employee
Other Company
Self
Eduction / US Military
Education
*
I am currently attending high school.
I am a high school graduate/have my GED.
I am attending college (in Lake Charles).
I am attending college (outside of Lake Charles).
I am a college graduate.
I am not in school.
Check all that apply.
Have you ever served in the U.S. Armed Services?
*
Yes
No
Prior Work Experience
Please list most recent position first with Employer name, Position held, start date, time at employer, reason for leaving, and supervisor name and phone number.
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Street Address
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Country
Phone
Position Held
Start Date
Date Format: MM slash DD slash YYYY
Years in Position
Supervisor Name
Description of Duties
Reason for leaving.
May we contact this employer?
Yes
No
Did you have another job before this one?
*
Yes
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Employer Name
Address
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Armed Forces Americas
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State
ZIP Code
Phone
Position Held
Start Date
Date Format: MM slash DD slash YYYY
Years in Position
Supervisor Name
Description of Duties
Reason for leaving.
May we contact this employer?
Yes
No
Would you like to list a 3rd employer?
Yes
No
Employer Name
Address
Street Address
City
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California
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Hawaii
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Illinois
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Iowa
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Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
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Ohio
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Oregon
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South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
Position Held
Start Date
Date Format: MM slash DD slash YYYY
Years in Position
Supervisor Name
Description of Duties
Reason for leaving.
May we contact this employer?
Yes
No
Third Choice
References
List 3-5 people we may contact who are qualified to evaluate your capabilities. Do not include relatives. (Click the + button to add a new row)
Name
Phone
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Years Known
Acknowledgement
Digital Signature
Printing your First Name + Middle Initial + Last Name will act as your digital signature.
Date
Date Format: MM slash DD slash YYYY
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If you have a resume you'd like to attach, please do so here. This is not required.
Cover Letter (optional)
Accepted file types: oc, docx, pages, odt, rtf, tex, txt, wpd, wps, pdf.
Please upload your cover letter here. You may also copy and paste the contents of your cover letter in the space below.
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