APPLICATION FOR EMPLOYMENT
TIERRA MIA COFFEE COMPANY IS AN EQUAL OPPORTUNITY EMPLOYER COMMITTED TO NON-DISCRIMINATION AND DIVERSITY.
(PLEASE PRINT CLEARLY AND ANSWER ALL QUESTIONS)
PERSONAL INFORMATION
Name (last, first, middle): ____________________________________________ Social Security Number:_____________________
Address (street, city, state, zip): _________________________________________________________________________________
Cell phone: __________________ Home phone: ___________________ Email: __________________________________________
Are you 16 or over? Yes ____ No ____ |
(Note: If you are under 18, a work permit may be required for compliance with federal or state law.) |
Are you legally eligible to work in the U.S.? |
Yes ____ No ____ |
(Proof of eligibility to work in the U.S. will be required upon employment.) |
Have you ever been convicted of a crime? If yes, please explain: |
Yes ____ No ____ |
__________________________________________________________________________________________________________
(Note: You need not identify convictions that have been sealed, expunged, dismissed, or otherwise eradicated by statute or court order, any conviction for a marijuana offense if the conviction is more than two years old. A conviction will not necessarily prevent you from obtaining employment.)
Position applying for: ____________________ How did you learn about the position?: _________________________________
AVAILABILITY
Please list the times that you are available to work on each day (For example: 6AM – 12PM, 12PM – 5PM, 5PM – 12AM):
Select 2 periods you would generally prefer to work: |
6AM-12PM ____ 12PM-5PM ____ 5PM-12 midnight ____ |
Total hours available each week: Minimum _______ |
Maximum _______ |
How long would you like to work for Tierra Mia Coffee Company?: 8-12 Months ____ 1 year or more ____ 2 years or more ____
EDUCATION
Name and Address of School |
Circle Last Year Completed Did you graduate? |
EXTRA-CURRICULAR ACTIVITIES
Hours per Week Position/s Held
WORK EXPERIENCE
Please start with most your recent job, listing paid or relevant non-paid positions.
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REFERENCES
Please provide the names and contact information for three professional references.
How acquainted? |
Yrs/Month Known |
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ADDITIONAL INFORMATION
Provide 3 reasons why you want to work for Tierra Mia Coffee Company! ______________________________________________
____________________________________________________________________________
How often do you drink coffee? What are your 2 favorite coffee beverages? _____________________________________________
Do you speak any foreign languages fluently or near fluently? Please explain. ___________________________________________
What makes you a good candidate for Tierra Mia Coffee? ____________________________________________________________
I declare that the information given in this application is true and complete to the best of my knowledge. I understand that false or misleading information provided in my application or interview(s) may result in my not being hired, or if hired, in my termination of employment. I hereby authorize Tierra Mia Coffee Company to investigate information and statements contained in this Application For Employment, and I hereby release any present employers and past employers from all liability and damages arising from any and all information they may provide regarding my employment with them. I understand nothing contained in this application or any subsequent interviews is intended to create an employment contract. I understand that if I am hired by Tierra Mia Coffee Company, my employment will be at will, meaning that it is not for a specific period and may be terminated by either me or Tierra Mia Coffee Company at any time without any reason or advance notice.
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Applicant Signature |
Date |