Online Application for Employment
Prospective employees will receive consideration
without discrimination because of race,
creed, color, sex, age, national origin or handicap.
*required
fields
Personal Information
Last Name*
First Name*
MI
Street Address*
City* State *
Zip code* Primary
Phone*
Secondary Phone
Email Address *
Have you ever applied for
employment with us yes no
if yes: month/year
Position Desired
Barista Pastry/Bread
Department
Pay expected *
When will you be available to begin work*
Will you work overtime if asked
yes no
Apart from absence for
religious observances, are you available for full-time work? yes no
If not what hours can you work: (Please
select the days you are available:)
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Please select the hours available Nights Daytime
Education
College
School name Course
of study Did
you graduate yes no
Number of years completed Degree
or diploma
High School
School name * Course
of study Did
you graduate yes no
Number of years completed Degree
or diploma
Other/Trade School
School name Course
of study Did
you graduate yes no
Number of years completed
Degree or diploma
Military
Branch of service
Period of active Duty from
to
Rank at discharge
Date of final discharge
Work History
Present and previous
employment history
Date of employment from* to * Company*
Address Telephone
weekly pay start last
Reason for leaving Name
of Supervisor
State job title Describe
your work
May we contact them for
reference yes no
if not, why?
Date of employment from to Company
Address Telephone
weekly pay start last
Reason for leaving Name
of Supervisor
State job title Describe
your work
May we contact them for
reference yes no
if not, why?
What Special Training do you have? ( languages, machine
operation, etc.)
How did you hear about our company?
I hereby declare the
information provided by me in this Application for Employment is
true, correct and complete to the best of my knowledge. I
understand that if employed, any misstatement or omission of facts
on this application shall be considered cause for dismissal. I
authorize you to obtain an investigative consumer report
containing information obtained through personal interviews with
my neighbors, friends and acquaintances, This report, if obtained,
may include information as to my character, general reputation,
personal characteristics and mode of living. I understand I have
the right to make a written report within a reasonable period to
receive additional detailed information about the nature and scope
of any such investigation.
I UNDERSTAND THAT NOTHING
CONTAINED IN THIS EMPLOYMENT APPLICATION OR IN THE GRANTING OF AN
INTERVIEW IS INTENDED TO CREATE AN EMPLOYMENT CONTRACT BETWEEN THE
COMPANY AND MYSELF FOR EITHER EMPLOYMENT OR FOR THE PROVIDING OF
ANY BENEFIT. NO PROMISES REGARDING EMPLOYMENT HAVE BEEN MADE TO
ME, AND I UNDERSTAND THAT NO SUCH PROMISE OR GUARANTEE IS BINDING
UPON THE COMPANY UNLESS MADE IN WRITING AND SIGNED BY THE
PRESIDENT OF THE COMPANY. IF AN EMPLOYMENT RELATIONSHIP IS
ESTABLISHED, I UNDERSTAND THAT I HAVE THE RIGHT TO TERMINATE MY
EMPLOYMENT AT ANY TIME AND THAT THE COMPANY MAY TERMINATE MY
EMPLOYMENT WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT
ANY TIME. I ALSO UNDERSTAND THAT NO POLICIES, PROCEDURES, RULES OR
REGULATIONS OF THE COMPANY CONSTITUTE A CONTRACT OF EMPLOYMENT
WITH ME, AND THAT SUCH POLICIES OR PROCEDURES MAY BE CHANGED FROM
TIME TO TIME, INTERPRETED, WITHDRAWN OR ADDED BY THE COMPANY AT
ANY TIME.
