Personal Information

Full Name:

Social Security #:

Present Address:

Permanent Address:

Personal Phone:

Other Phone:

E-mail:

Which Store do you want to work at: Downtown TC GTHOP Corner of S. Airport and Garfield Both Stores Either store or the other

Have you ever worked under another name?  Yes No

If yes, list:

Position Desired:   Cashier, Drink Preparation, Bus Person, Manager, Coffee, Gelato, Smoothies

Salary Expected:

I Can Work: Full Time Part Time Temporary Permanent Summer

How many hours per week do you want to work? Minimum   Ideal         Maximum  September   How many Hours per week can you work in September? Times Available: Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays Sundays     Days Evenings Nights Holidays Overtime Split Shifts Any Time What times can you NOT work What weeks can you NOT work    Employment Record Record your most recent position first. Failure to accurately account for all periods during the last Five years may lead to your application not being considered. If omissions or falsifications are discovered subsequent to your employment, such omissions or falsification will be sufficient cause for discharge (List periods of school as follows: School name under company name & dates attended.) Employer #1 (most recent) Company Name: Company Address: Supervisor Name: Phone Number: Job Titles & Duties: Reason for Leaving: Starting Date:  Ending:  Starting Wage:  Ending:  Were you unemployed between positions?  Yes No How long and why? Employer #2 Company Name: Company Address: Supervisor Name: Phone Number: Job Titles & Duties: Reason for Leaving: Starting Date:  Ending:  Starting Wage:  Ending:  Were you unemployed between positions?  Yes No How long and why? Employer #3 Company Name: Company Address: Supervisor Name: Phone Number: Job Titles & Duties: Reason for Leaving: Starting Date:  Ending:  Starting Wage:  Ending:  Were you unemployed between positions?  Yes No How long and why? Have you ever been asked to resign or been fired for cause? Yes No May we contact your previous employers? Yes No Please list any previous employers you wish us not to contact:    Educational Record Years Completed: Select 9th grade High School 10th grade High School 11th Grade 12th Grade Freshman College Sophmore College Junior College Senior College College Graduate High School Name: Area of concentration: GPA: Course Work: (Best/Worse courses) Trade School Name: Degree Received: GPA: Course Work: (Best/Worse courses) College Name: Degree Received: GPA: Course Work: (Best/Worse courses)    Other Information Outside Activities or Hobbies: What kind of transportation do you have to get to and from work? Make and Year?   Is it reliable? Yes No Have you ever been denied a bond?   Yes No Have you ever been convicted of a felony or misdemeanor other than a traffic violation?   Yes No If yes, please explain: (Such conviction may be relevant if job related, but does not bar you from employment.) Military Service Are you now, or have you ever been in the military?   Yes No If yes, list branch of service and highest rank attained: If in reserves, are you currently active?   Yes No Immigration Status If an alien, do you have a legal right to be in the U.S.?   Yes No If an alien, do you have a legal right to accept employment in the U.S.?   Yes No (Upon employment, verification of legal employment status will be required.)    References Name: Title: Phone: Years Known: Name: Title: Phone: Years Known: Name: Title: Phone: Years Known:    Important! Please Read Carefully I hereby authorize investigation of all statements contained in this application, including inquiry of any and all of my former employers or references as indicated elsewhere on this application, and hold said former employers and/or references harmless from liability arising therefrom. I affirm that all the information contained in this application and all information provided verbally prior to employment is true and correct, and that any misrepresentation, falsification or omission herein shall be sufficient reason for dismissal from, or refusal for employment. If employed, I understand that the company reserves the right to modify or terminate my employment at any time, with or without cause, and without prior notice. I further understand that the duration, hours, nature, compensation and benefits of my employment may be changed or modified from time to time without limitation or condition. I understand that no representative of the company has any authority to make any assertions to the contrary. I hereby agree to abide by all policies and rules of this company which govern dress, hair, grooming and attitude.