Date of application *

MM

DD

YYYY

Position applying for: *

Check all that apply

The Coffee House

Liars' Club

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Are you over 18 years of age? *

Yes

No

Have you ever been convicted of a crime? (A conviction will not disqualify you from employment) *

Yes

No

Education (Check all that apply):

High School / GED

Some College

2-year degree

4-year degree

Currently attending

Availability (check all that apply):

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, sex, age, national origin, marital status, or disability. The information provided on this application is subject to verification. Falsification or misrepresentations may disqualify you from consideration for employment, or if hired, may be grounds for termination at a later date. Do you want to be informed before we contact your present employer? *

Yes

No

Date *

MM

DD

YYYY