Note: This application for employment is good for 60 days only. Consideration for employment after 60 days requires a new application.

Today's Date: 12-13-2017

Personal Information:

Full Name: Address: City, State: Zip:
Email: Phone: How did you hear about us?:
Are you over 18 years old?  Yes:  No: Are you legally eligible for employment in the United States?  Yes:  No:

Employment Desired:

Position: Location: Salary/Wage: Start Date:
Have you applied with us before?:    Where and When:

Availability:

M: Tu: W: Th: F: Sa: Su:

Education:

NameYearsStudy/DegreeGraduate?
High SchoolYes:
CollegeYes:
Post GradYes:
Business or Trade SchoolYes:

Military Service and Rank
Special study/training/skills:
Skills relevant to desired position:
Computer Proficiency (Word, Excel, Access, etc...):

Former Employers: please list current/most recent employer first.

Employer: Address: Ph. #: Type of Business:
Position: Wage: Supervisor: Start/End Date:
Duties Performed: Reason for Leaving:

Employer: Address: Ph. #: Type of Business:
Position: Wage: Supervisor: Start/End Date:
Duties Performed: Reason for Leaving:

Employer: Address: Ph. #: Type of Business:
Position: Wage: Supervisor: Start/End Date:
Duties Performed: Reason for Leaving:

References: List the names of three professional references whom you have known for at least 1 year.

#NameCity,StPhoneBusinessRelationYears known
1
2
3

Additional Information:

What do you like about coffee/tea?
Why would you like to work for Colectivo?
Describe your best customer service experience:
Anything else you would like to tell us?

Authorization: Please read below and check the box if agreed.

I agree:

"I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Colectivo Coffee to verify their accuracy and to obtain reference information on my work performance. I hereby release Colectivo Coffee from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause."

Spam Check: Please enter the word colectivo in this box:

Colectivo Coffee is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex marital status, national origin, disability or handicap, or veteran status.