Coffee Waves Application for Employment

Application for Employment
Application for Employment JROX Coffee Co. is an equal opportunity employer, dedicated to a policy of non-discrimination in employment any basis including race, color, age, gender, religion, national origin, the presence of mental, correctphysical, or sensory disability, sexual orientation, or any other basis prohibited by federal, state, or provincial law.
Name

First NameLast Name
Middle Initial
Social Security Number
123-45-6789
Date of Birth

MonthDayYear
Date
US Applicant Only
Are you under 18 years of age?

YesNo
Are you legally eligible for employment in the U.S.?

YesNo
Have you been convicted of a crime in the last seven years?

YesNo
If yes list convictions that are a matter of public record arrests are not convictions A conviction will not necessarily disqualify you for employment.
Present Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permanent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Daytime
Evening
Referred By
Employment Desired

If you are applying for a retail hourly position, please keep in mind that the availability of hours may vary
Position - Select One

BaristaKitchenFood Prep
Availability
When Can You Start?

Education

	Name and Address of School	Years Completed	Did You Graduate?	Subjects Studied and Degrees Received
High School
College
Post College
Trade, Business, or correspondence school

List Skills Relevant to the position applying for
Have you ever worked at an establishment that serves food?
What do you like about Coffee?
Why would you like to work for Coffee Waves?
Do you work well with others and are you a team player?
Former Employers

List below current and last three employers starting with most recent one first. Please include anynon-paid/volunteer experience which is related to the job for which you are applying. Please complete even ifyou attach a resume.

Previous Employer 2
Previous Employer
From

MonthDayYear
Date
To

MonthDayYear
Date
Salary Starting
Salary Ending
Position
Duties Performed
If hourly give average number of hours per week
Reason for Leaving
Supervisors Name
May we contact?
References

Give below the names of three professional references that you have known at least one year.

	Name	Address	Phone	Business	Years Acquainted/Relationship
1
2
3

Upload Your Resume

Cancelof
I hereby authorize Coffee Waves to thoroughly investigate my background, references, employment records and other matters related to my suitability for employment. I authorize persons, schools, my current employer (if applicable) and my previous employers and organizations contacted by Coffee Waves to provide any relevant information regarding my current and/or previous employment and I release all persons, schools, employers of any and all claims for providing such information. I understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up toand including dismissal. I understand that I may be required to sign a confidentiality and/or non-compete agreement, should I become an employer of Coffee Waves. I understand that nothing contained in this application, or conveyed during any interview which may be granted in intended to create an employment contract. I understand that filling out this form does not indicate there is a position open and does not obligate Coffee Waves to hire me. I understand and agree that my employment is at will, which means that it is for no specified period and may be terminated by me or Coffee Waves at any time without prior notice for any reason.
Date

MonthDayYear
Date
Signature

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Application for Employment