Exchange Employment Application

THE EXCHANGE COFFEE, MERCANTILE & EATERY

EMPLOYMENT APPLICATION
Full Name:*

First Name & Middle InitialLast Name
Birth Date*

MonthDayYear
Phone Number:*

Area CodePhone Number
E-mail Address:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How were you referred to us?*

Walk-InEmployeeIndeedFacebookInstagramOther (please specify)Friend/Word of Mouth
Others:
Are you legally eligible for employment in the U.S.? (Proof of U.S. Citizenship or immigration status is required if hired).*

YesNo
Would you be willing to complete a drug screening if asked?*

YesNo
Have you ever been convicted of a felony? (A conviction will not necessarily bar you from employment).*

YesNo
If you answered 'Yes" to the previous question, please explain briefly.
Brief explanation of felony.
What do you like to do in your free time?*
Let us know!

EMPLOYMENT DESIRED
Position(s) seeking: *
Are you seeking full-time, part-time, or seasonal employment (i.e. summer or winter break)?*
Hours desired per week: *
Date available to start*

MonthDayYear
Date
Why do you want to work at The Exchange?*
Do you have reliable transportation?*

YesNoOther
Are you currently employed?*

YesNo
If you answered 'Yes' to the previous question, what is your current occupation?
We will need staff to cover the following hours (subject to change): Monday-Saturday, 6 am-3:30 pm. Please specify your typical hours available each day of the week (we understand this is also subject to change). *
Please note any other schedule-related comments.

EDUCATION
EDUCATION. Please list High School in Row 1, College (if applicable) in Row 2, and Business/Trade School (if applicable) in Row 3.
Please list additional skills relevant to the position(s) you are applying for: *