Maple Buzz Cafe Job Application Form

Full Name*

First NameMiddle NameLast Name

Birth Date*

Date

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email Address*

example@example.com

Phone Number*

Desired Position*

How did you hear about us*

Available Start Date*

Employment Desired (select all that apply)*

Full TimePart TimeSeasonalWeekends Only

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 Maple Buzz Cafe?*

YesNo

If so, when did you start?

When did your employment end?

Desired Weekly Hours*

Tuesday*

Start Time

End Time

Wednesday*

Start Time

End Time

Thursday*

Start Time

End Time

Friday*

Start Time

End Time

Saturday*

Start Time

End Time

Does this availability change?*

YesNo

High School Name*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Start Date*

Date

End Date

Date

Did you graduate?*

YesNo

College Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Start Date

Date

End Date

Date

Did you graduate?

YesNo

Degree

Company Name

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Company Phone Number

.

Supervisor Name

First NameLast Name

Job Title

Starting Hourly Wage/Salary

Ending Hourly Wage/Salary

Job Responsibilities

Reason for Leaving

Company Name

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Company Phone Number

.

Supervisor Name

First NameLast Name

Job Title

Starting Hourly Wage/Salary

Ending Hourly Wage/Salary

Job Responsibilities

Reason for Leaving

Company Name

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Company Phone Number

.

Supervisor Name

First NameLast Name

Job Title

Starting Hourly Wage/Salary

Ending Hourly Wage/Salary

Job Responsibilities

Reason for Leaving

Reference Name*

First NameLast Name

Relationship*

Company*

Phone Number*

Email*

example@example.com

Reference Name*

First NameLast Name

Relationship*

Company*

Phone Number*

Email*

example@example.com

Reference Name*

First NameLast Name

Relationship*

Company*

Phone Number*

Email*

example@example.com

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may
result in my release.

Signature*

Maple Buzz Cafe Job Application

General Information

Employment Information

General Availability

Education: High School

Education: College

Employment History

References

Employee Disclaimer and Signature