Cafe Employment Application

Name

Address (Street, City, State, Zip)

Phone Number

Have you ever worked in a cafe/related environment before, and if YES, when/where?

Are you 16 years of age or over (proof of age or work permit may be required)?

Yes
No

Are you legally able to be employed in this country (If hired, verification will be required by law)?

Yes
No

What type of position are you seeking?

Full-Time
Part-Time
Seasonal
Temporary

Are you able to meet the attendance requirement of the position?

Yes
No

Total hours available per week

Date available to start work

Monday Availability

Tuesday Availability

Wednesday Availability

Thursday Availability

Friday Availability

Saturday Availability

Sunday Availability

High School Name, City, State

High School Years Attended

High School Degree/Courses

College Name, City, State

College Years Attended

College Degree/Courses

Activities/Other Training

Most Recent Employer

Address

Job Title

Supervisor

Phone Number

Date Started

Date Left and Reason for Leaving

Starting Salary/Wage (Please specifiy Hourly, Weekly, or Yearly)

Ending Salary/Wage (Please specifiy Hourly, Weekly, or Yearly)

2nd Most Recent Employer

Address

Job Title

Supervisor

Phone Number

Date Started

Date Left and Reason for Leaving

Starting Salary/Wage (Please specifiy Hourly, Weekly, or Yearly)

Ending Salary/Wage (Please specifiy Hourly, Weekly, or Yearly)

1st Reference Name

Relation/Years Known

Phone Number

2nd Reference Name

Relation/Years Known

Phone Number

Agreement

I certify that I have read and fully completed this form and that the information contained herein is correct to the best of my knowledge. I understand that any omission or false information is grounds for dismissal. I authorize the references listed on this application to give the employer any and all information concerning my previous employment and pertinent information they may have, personal and otherwise. I understand that as a part of the procedure for my employment application an investigative consumer report may be made by the employer concerning my character, general reputation, personal characteristics and mode of living. This establishment is an Equal Opportunity Employer. Various federal, state, and local laws prohibit discrimination on account of race, color, religion, sex, age, national origin, disability or veterans status. Completing this field is required for your application to be considered. I acknowledge that I am applying for employment with this establishment.

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