Black Cow Coffee Co. Employment Application
For what location are you applying?
Croton
Phelps
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Why do you want to work at the Black Cow?
*
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Employment History
#1
Name of Employer
*
Title/Responsibilities
*
Employment Dates
*
Reason for leaving?
*
May we contact this employer (if so please give us contact info below)
*
yes
no
Phone number and/or email of employer
*
#2
Name of employer
Title/Responsibilites
Employment Dates
Reason for leaving?
May we contact this employer (if so please give us contact info below)
yes
no
Phone number and/or email of employer
#3
Name of employer
Title/Responsibilites
Employment Dates
Reason for leaving?
May we contact this employer (if so please give us contact info below)
yes
no
Phone number and/or email of employer
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Are you able to lift up to 25lbs?
*
Yes
No
Are you legally eligible to work in the United States?
*
Yes
No
Have you ever been convicted of a crime in NY or any other US jurisdiction (felony or misdemeanor other than minor traffic violation)?
*
Yes
No
Are there any criminal actions in the US or US territories pending against you presently?
*
Yes
No
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References
Please provide at least two references that we can contact. (We won't contact anyone without letting you know first.)
Name/Relationship/Phone # or email
*
Name/Relationship/Phone # or email
*
Name/Relationship/Phone # or email
Availability
Please select all times that you are available
Rows
Morning
Afternoon/Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
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By signing below, I certify that the information provided in this application is true and complete to the best of my knowledge.
Submit
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