Application for Employment at Ebenezers

							                                                                  Date Received:_____


                            The Coffee Loft
                        Application for Employment
                                5025 N. Tamiami Trail
                                 Sarasota, FL 34234
                                   (202) 558-6900
                            http://www.coffeeloft41.com
                               Carla@coffeeloft41.com

Personal Information
Name:                                      Email:
Address:                                   City, State, Zip:
Cell Phone:                                Home or Work Phone:
Social Security Number:
Are you less than 18 years of age? Yes       No
Are you legally eligible for employment in the U.S.? Yes     No
Please list any other names you are known by or names previously used:
Most recent prior address:         City, State, Zip:

Employment Desired
Why do you want to work at The Coffee Loft?

How did you hear about The Coffee Loft or by whom were you referred?

For what position are you applying?

List skills related to the position for which you are applying:

We will need staff to cover the following hours (subject to change):
Mon-Thurs: 6:30am-10:00pm                 Fri: 6:30am-10:00pm
Sat: 7:30am-10:00pm                       Sun: 7:00am-10:00pm

Please list your hours of availability:
Monday:                                    Tuesday:
Wednesday:                                 Thursday:
Friday:                                    Saturday:
Sunday:

How many hours per week would you like to work?

What date can you start?




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                                                              Date Received:_____


For what period of time do you anticipate your availability remaining the same as
listed above? (i.e. for the next 3 months until my school schedule changes, or I
plan to be in the Sarasota area for the next 6 months, etc.):

Please list any other schedule related comments:


Education
List the name and address of the high school, college, trade school, and/or other
education. Include number of years attended, year graduated (if applicable),
course of study and degree received:


Past Employment
Please describe any past experience (work or non-work related) that you have
had that you feel will help you positively contribute to The Coffee Loft:

List your three most recent employers:
Company Name:
Address:
Duties Performed:
Reason for Leaving:
Length of employment (list approximate dates):
Contact person/manager:
Phone:                                 Email:
May we contact this person? Yes     No

Company Name:
Address:
Duties Performed:
Reason for Leaving:
Length of employment (list approximate dates):
Contact person/manager:
Phone:                                 Email:
May we contact this person? Yes    No

Company Name:
Address:
Duties Performed:
Reason for Leaving:
Length of employment (list approximate dates):
Contact person/manager:
Phone:                                 Email:
May we contact this person? Yes    No


                                                                                2
                                                                            Date Received:_____



Additional Questions
What are your thoughts on customer service?

What are you feelings on coffee?

References
List two references that are not related to you:
Name:
How do you know the person?
For how long have you known the person?
Phone:                                    Email:

Name:
How do you know the person?
For how long have you known the person?
Phone:                               Email:

I hereby authorize The Coffee Loft to investigate my background, references, and other matters
related to my suitability for employment. I authorize individuals, schools, current/past employers,
and organizations contacted by The Coffee Loft to provide any relevant information regarding my
current and/or previous employment. I understand that misrepresentation or omission of facts
may result in rejection of this application, or if hired, discipline up to and including discharge. I
understand that I may be required to sign a confidentiality agreement should I become an
employee of The Coffee Loft. I understand that nothing contained in this application, or conveyed
during an interview which may be granted is intended to create an employment contract. Finally,
I understand that filling out this form does not indicate there is a position available and does not
obligate The Coffee Loft to make an offer of employment to me.



________________________
Signature

Printed Name:

Date:




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