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Name

Email Address

Phone Number

Street Address

City, State

Preferred Location
—Please choose an option—Traveler's RestPMIC Pickwick

Position Applying For
—Please choose an option—Location LeadScooper

Expected Hourly Salary

Date Available to Start

Availability (Check all that Apply)
Full TimePart TimeNightsWeekendsSeasonal

Are you 16 or older?
YesNo

Have you ever applied to / worked for Pink Mama's Ice Cream before?
YesNo

Do you have any friends or relatives working for Pink Mama's Ice Cream?
YesNo

If yes, state their name & relationship:

Have you been convicted of or pleaded no contest to a felony within the last five years?
YesNo