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Application for Employment
Java Crew Is A Drug Free Environment

Personal Information
Name:
Address:
Phone:
Email:
Date Avaliable:

General Questions
Have you ever applied at Java Crew before? Yes No
If so when?
Do you have a food handlers card? Yes No
If so when does it expire?
Would this be your only job? Yes No
If not please explain:
How do you plan to get to work?
Have you ever made espresso drinks before? Yes No
If so, when and where?
Name some of the activities you do outside of work:
Are you 18 or older? Yes No
Are you willing to work at least 2 shifts a month outside of your regular schedule? Yes No
If no explain why:
Have you ever been convicted of a felony?
(This does not necessarily mean that you are barred from employment.)		 Yes No
If yes, explain:
Here at Java Crew we consider ourselves to be positive, proactive, and responsible team players. What further qualities can you contribute to our team?
Do you have any possible schedueling conflicts? Yes No
If so, please explain:

Availability
What kind of scheduling are you looking for? (Checkmark the following)
Full Time Part Time Both

Weekends Weekdays Both

AM PM Both
We have several locations and your flexibility to work at various locations is an important factor in our selection process. Below are the general locations, please mark the ones you would be willing to work at.
West Salem West 22 South Salem Redmond Woodburn Roth's Vista Albany

Please give us the availability of your average week including where and when you are unavailable. Use terminology like “all day”, “3:00pm on”, “Ams until 2:45”, “every other week”, “Not available” ect… Please fill out the entire week.
Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Job Experience
Please fill out the section below telling us about your previous employment.

1 Company:
 Phone:
 Address:
Job Description:
 Employment Period:
From: //
To: //

Reason For Leaving:
2 Company:
 Phone:
 Address:
Job Description:
 Employment Period:
From: //
To: //

Reason For Leaving:
3 Company:
 Phone:
 Address:
Job Description:
 Employment Period:
From: //
To: //

Reason For Leaving:
4 Company:
 Phone:
 Address:
Job Description:
 Employment Period:
From: //
To: //

Reason For Leaving:

Education Information
Please fill out the section below telling us about your education background.

High School:
 Address/Phone:
 Favorite Subjects:
 Date Completed:
College, trade or other:
 Address/Phone:
 Major & Minor:
 Degree & Date Completed:

Personal References
Please fill out the section below telling us about your personal references.

Name Relationship Phone # Occupation

Java Crew is an equal opportunity employer. Our company does not discriminate on the basis of age, race, religion, color, sex, national origin, marital status, physical or mental disability or arrest record.

I certify that the information contained in this application is correct to the best of my knowledge, and I understand that falsifications and/or omissions in any detail are grounds for disqualification from consideration for employment or if hired are grounds for dismissal from employment. I further understand that if hired, my employment and compensation can be terminated, with or without cause, and with or without notice at any time, at the option of either myself or the company.

Signed:  Date: 

Authorization for Release of Information The following “Authorization for Release of Information” is required of all applicants at Java Crew. This is a required part of the job application. By not completing the following information you forfeit your ability to become a Java Crew employee.

I (print name)  hereby authorize my past employers to release information to Java Crew regarding my employment. This release of information covers my employment record in general, including information on the following questions.

  1. Dates of employment.
  2. Position(s) held.
  3. The quality and quantity of my work.
  4. My attendance habits (excluding workers’ compensation, pregnancy, disability and legally protected absences).
  5. My relationship with co-workers and supervisors.
  6. My attitude toward work (cooperative? Positive? Ect.).
  7. Reason for leaving and eligibility for rehire.
  8. Strong and weak points.
  9. Whether I have had outbursts of temper, threatened, provoked fights with or assaulted others, engaged in hostile or violent behavior, have a criminal record or any traits that would present security or safety issues for others.
  10. Other relevant information regarding my performance, skills, ability, suitability for employment ect...

I agree that all former employers who provide such information are indemnified and released from liability arising from such disclosures.

Signed:  Date: