Employment Application

Employment Application
Personal Information:
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
E-mail
example@example.com
Are You a U.S. Citizen?*

YesNo
Will you now, or in the future, require sponsorship for employment visa status (e.g. H1-B visa status)?

YesNo
Employment Desired:
TYPE OF EMPLOYMENT DESIRED

Full-timePart-timeTemporarySeasonalAny
POSITION DESIRED

Retail StoreCafeOrder FillingFactory/ProductionAny
Date You Can Start*

MonthDayYear
Date
Salary Desired ($)
Have You applied here before?

YesNo
Education:
High School
Name of High School Attended
Number of Years Attended
Graduated?

YesNo
College
Name of College/University Attended
Number of Years Attended
Area of Study/Degree
Graduated?

YesNo
Trade/Technical
Name of Graduate School Attended
Number of Years Attended
Area of Study/Degree
Graduated?

YesNo
College
Name of Trade/Technical/Other School Attended
Number of Years Attended
Area of Study/Degree
Graduated?

YesNo
Skills/Qualifications:
Skills & Qualifications
List any relevant skills
Current Employment:
Current Employer
Name of Current Employer or NONE if not Employed
Position
Current Salary ($)
Reason for Leaving?
Start Date

MonthDayYear
Date
May We Contact?

YesNo
Previous Employment:
Previous Employer
Name of Previous Employer
Position
Previous Salary ($)
Reason for Leaving?
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Previous Employer
Name of Previous Employer
Position
Previous Salary ($)
Reason for Leaving?
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
References:
Reference 1
Name of Reference
Relationship
Years Acquainted
Phone Number
Please enter a valid phone number.
Email
example@example.com
Reference 2
Name of Reference
Relationship
Years Acquainted
Phone Number
Please enter a valid phone number.
Email
example@example.com
Reference 3
Name of Reference
Relationship
Years Acquainted
Email
example@example.com
Phone Number
Please enter a valid phone number.
COMMENTS
Application Statement

Read Application Terms below, then agree before submitting
Todays Date

MonthDayYear
Door County Coffee & Tea Co. is an Equal Opportunity Employer. We consider all applicants for positions without regard to race, color, religion, sex, national origin, citizenship, age, sexual orientation, mental/physical disabilities, veteran/reserve/national guard or any other similarly protected status. We also comply with all applicable laws governing employment practices and do not discriminate on the basis of any unlawful criteria.
Should be Empty:

Employment Application

Personal Information:

Employment Desired:

Education:

Skills/Qualifications:

Current Employment:

Previous Employment:

References:

Application Statement