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Application Information

First name*

Last name*

Birthday*

Month

Day

Year

Phone*

Email*

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

Are you a citizen of the United States?*

Yes

No

If no, are you authorized to work in the United States?

Yes

No

Do you have any previous work experience in a coffee shop?*

Yes

No

If yes, when?

Have you ever been convicted of a felony?*

Yes

No

If yes, explain:

Availability

Hours of Operation:

Mon - Sat ---> 6am-8pm

Sunday ---> 7am-8pm

When can you start:*

Desired rate of pay:*

Please state your available time per day:

Monday*

Tuesday*

Wednesday*

Thursday*

Friday*

Saturday*

Sunday*

Education

Highest level of education completed:*

What school:*

Did you graduate*

Yes

No

References

Please list two professional references.

Reference #1:

Full Name:

Relationship:

Email:

Phone:

Company:

Reference #2:

Full Name:

Relationship:

Email:

Phone:

Company:

Previous Employment

Company:

Phone:

Address:

Supervisor:

Job Title:

Date worked:

Responsibilities:

Company:

Phone:

Address:

Supervisor:

Job Title:

Date worked:

Responsibilities:

Disclaimer & Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature*

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Date signed*

Month

Day

Year

The Daily Drip

710 Joliet St, Dyer, IN 46311

thedailydripcoffee1@gmail.com

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