*
Name
*
First Name
Last Name
Phone
*
(###)
###
####
Email Address
*
Home Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Referred By:
Have you been referred/encouraged to apply with us by someone who currently works at Coffee Emporium?
First Name
Last Name
Do you have dependable transportation to work?
*
Yes
No
*
Are you a student?
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Yes
No
Type of Employment Desired
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Part Time (24-34 Hours/Week, Long-Term)
Full Time (34-40 Hours/Week, Long-Term)
Date Available to Start Work
*
MM
DD
YYYY
Describe your availability:
*
Are you available for a 4 AM or 6 AM start time?
*
Check all that apply
Have you ever pleaded "Guilty," "No Contest," or been convicted of a crime?
*
Yes
No
If yes, please explain. A conviction will not bar you from employment.
Have you ever been dismissed or terminated from a position?
*
Yes
No
If yes, please explain.
Most Recent Employer
*
Employer Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Start Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Position Held
*
Supervisor's Name & Phone Number
Job Summary
*
Reason for Leaving
*
Previous Employer
*
Employer Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Start Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Position Held
*
Supervisor's Name & Phone Number
Job Description
*
Reason for Leaving
*
How do your personal values align with Coffee Emporium's mission?
What does "intentional customer service" mean to you, and how would you apply it to your interactions with guests at Coffee Emporium?
How would you describe your personality? More introverted, more extroverted, mostly ambivert? Why?
Authorization
*
I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.
I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for
cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.
If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.
I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.
I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.
