Leader's Corner Coffee & Tea Employment Inquiry Form

Leader's Corner Coffee & Tea™

Employment Inquiry Form
Today's Date

MonthDayYear
Date
Name*

First NameLast Name
Street Address
Apartment/Unit
ZIP Code
E-mail Address*
example@example.com
Cell Phone Number*
Date of Birth*

MonthDayYear
Date
Date Available*

MonthDayYear
Date
Position You Are Interested In*

General ManagerBarista
Social Security No.
Salary/Hourly Rate Desired
Position Interested In
Are you a citizen of the United States?*

YESNO
If no, are you authorized to work in the United States?*

YESNO
Have you ever worked for this company?

YESNO
If so, when?
Have you ever been convicted of a felony?*

NOYESIf yes, explain:
If yes, explain
Education / Training
High School
Address
From
To
Did you graduate?

NOYES
Degree
College
Address
From
To
Did you graduate?

NOYES
Degree
Other
Address
From
To
Degree
Previous Employment
Company Name
Phone
Address
Supervisor
Job Title
Starting Rate of Pay
Ending Rate of Pay
What were your responsibilities?
Start Date
End Date
Reason for Leaving
Company Name
Phone
Address
Supervisor
Job Title
Starting Rate of Pay
End Rate of Pay
What were your responsibilities?
Start Date
Leave Date
Reason for Leaving
Miltary Service
Type of Service
From
To
Type of Discharge
If other than honorable, explain
Work Availability
Please note: We open at 6:00 AM and Close at 4:00 PM Monday - Thursday. 6:00 AM - 8:00PM Friday and 7:00 AM to 8:00 PM on Saturday.
Are there any limits to your availability?
Maximum # of hours per week you would like to work*
How did you hear about us?*

IndeedFacebookInstagramZip RecruiterSearch EngineWebsiteOther
Criminal History Background Information Checks:
Are there any criminal charges against you?*

YesNo
If yes, give details.
Are you willing to submit to a background check?*

YesNo
Disclaimer and Signature
By signing this form, I am affirming that the statements I have made in this inquiry form are true and factual to the best of my knowledge; and I am granting permission for all persons, organizations, or agencies listed above to be contacted for information regarding my background. If this inquiry leads to employment, I understand that false or misleading information in this inquiry or interview may result in immediate termination of my employment.
Sign Below*

Clear
Date*

MonthDayYear
Date
Please upload a PDF of your resume

Cancelof
Please upload a PDF of your cover letter expressing your interest. (Required for General Manager position.)

Cancelof
THANK YOU!!
Should be Empty:

Leader's Corner Coffee & Tea™

Work Availability

Criminal History Background Information Checks:

Disclaimer and Signature