COFFEE CUP CAFE

 

Personal Information                
First Name: Last Name: Middle Name:                    
Email: Phone Number: Are you over 18? Yes No Are you over 21? Yes No    
Present Address: City: State: Zip Code:      
Mailing Address: City: State: Zip Code:      

Have you applied at any of these locations in the past?

Coffee Cup Cafe       A Second Cup       Cowboy Cafe

Chuck Wagon Family Grill       None of the above

How were you referred to us?

 

If by Friend or Employee, who?

Select all that apply; use CTRL-click to select          
Are you legally able to work in the United States?    Yes No          
           Have you ever been convicted of a felony?    Yes No Have you ever been convicted of any drug or alcohol related charge?    Yes No  
Employment Desired                                            
Position: Date you can start: Salary Desired:                      
Are you employed?   Yes No If so, may we contact your present employer?    Yes No                      
Former Employers                                                            
Date
Month and Year
 
Employer Information
                                                   
From:

To:
Name of Employer:

Address of Employer:
Salary:

Position:
Reason for leaving:

Name of Supervisor:
                   
From:

To:
Name of Employer:

Address of Employer:
Salary:

Position:
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Name of Supervisor:
                   
From:

To:
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Address of Employer:
Salary:

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Reason for leaving:

Name of Supervisor:
                   
Education History                                                                    
  High School:

College:


Years Attend:

Years Attend:


 Did you graduate?

Did you graduate?
Yes No
 
Yes
No
Subjects studied:

Subjects studied:


References Give below the names of three persons not related to you, whom you have know at least one year.            
Name




Phone Number




Business




Years Known




                       
Days and Hours of Availability   Check the days you are available to work and enter the hours you are available, hours range from 5:30am until 4:00pm.  
Monday
From:

To:
Tuesday
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Wednesday
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Thursday
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Friday
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Saturday
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Sunday
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Interested in -
Full Time    Part Time
                                                                     

Please enter any further information you would like us to know.  Maximum of 1,000 characters.

       
Authorization              
By click on the "Submit" button "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
   I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
   I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
   This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."
       
               

© Copyright 2014 Coffee Cup Cafe. All Rights Reserved.
(719)488-0663 | 251 Front St. Suite #6 | Monument, CO 80132
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