Application for Employment - Philz Coffee

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					                                APPLICATION FOR EMPLOYMENT

   Philz Coffee INC. is an equal opportunity employer, dedicated to a policy of non-discrimination in
   employment on any basis including race, color, age, sex, religion, national origin, the presence of
mental, physical, or sensory disability, sexual orientation, or any other basis prohibited by federal, state,
                                                or local law.

Please complete entire application
PERSONAL INFORMATION: (please print)                                 Date:
Full Name:
Address:                                                   City/State/Zip:
Phone Number:                                                        EMail:
Referred by:
Are you at least 18 years of age?                                                   Yes  No 
(Philz Coffee Inc. is required to comply with federal, state, or provincial law.)
If you are under 18, are you able to obtain a work permit?                          Yes  No 
Are you legally eligible for employment in the U.S.?                                Yes  No 
Do you currently work at another coffee shop or café?                               Yes  No 
Have you ever been convicted of crime? If yes, please explain.                      Yes  No 




Have you applied at Philz Coffee before?                                            Yes  No 
If yes, when did you apply?         Date applied (if applicable) :
Have you attended any training sessions at Philz Coffee?                            Yes  No 
If yes, when did you attend? Date of training (if applicable) :
Have you ever been employed by Philz Coffee?                                        Yes  No 
If yes, what were the dates of your employment?

                                   Dates of employment (if applicable) :




                                                  Page 1 of 6                                        V4.10
EMPLOYMENT DESIRED:

Position                Location (1st,2nd,3rd, Choice)                        Salary Desired

__________________1st:__________2nd:___________3rd:_______________________$_____________

Earliest available start date: ________________________

Please indicate your complete availability to work: (Please write neatly)


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

Does your schedule change frequently?

______________________________________________________________________

How many hours are you looking to work weekly (minimum/maximum)?

______________________________________________________________________

Do you have any plans for time off in the next 3-6 months?

______________________________________________________________________

How long are you looking to work for?

______________________________________________________________________

What are your second and third choices for positions at Philz?

______________________________________________________________________


Would you consider growing with Philz long term? __________________________




                                               Page 2 of 6                              V4.10
EDUCATION:

High School

Name/Address                           Years Completed                  Graduated?

___________________________________________________________________________________

College/University

Name/Address                           Years Completed                  Graduated?

___________________________________________________________________________________

Extended Education

Name/Address                           Years Completed                  Graduated?

___________________________________________________________________________________

List your skills relevant to the position for which you are applying:

____________________________________________________________________________________

____________________________________________________________________________________

Have you ever visited a Philz Coffee? Where? Describe you experience




_____________________________________________________________________________

What do you like about coffee?




_____________________________________________________________________________

Why would you like to work for Philz Coffee?




_____________________________________________________________________________




                                              Page 3 of 6                            V4.10
What is one of the most important things you look for in a Job?

____________________________________________________________________________

____________________________________________________________________________

Describe a situation where you felt most appreciated at a job? What did you do?

____________________________________________________________________________________

____________________________________________________________________________

FORMER EMPLOYERS: List below current and last three employers, starting with most recent one first.
Please complete even if you attach a resume.

Current Employer: (If Applies)
Name of Company                        Location                     Position
______________________________________________________________________
Duties Performed                       Salary: Starting             Ending
______________________________________________________________________
Please state your reason for leaving
____________________________________________________________________
Manager/Supervisor Contact Information                    May We Contact?
___________________________________________________________________
Former Employer #1
Name of Company                        Location                     Position
______________________________________________________________________
Duties Performed                       Salary: Starting             Ending
______________________________________________________________________
Please state your reason for leaving
______________________________________________________________________
Manager/Supervisor Contact Information                    May We Contact?
______________________________________________________________________
Former Employer #2
Name of Company                        Location                      Position
______________________________________________________________________
Duties Performed                       Salary: Starting             Ending
______________________________________________________________________
Please state your reason for leaving
______________________________________________________________________
Manager/Supervisor Contact Information                              May we Contact?

______________________________________________________________________


                                             Page 4 of 6                                     V4.10
Former Employer #3
Name of Company                        Location                  Position
______________________________________________________________________
Duties Performed                       Salary: Starting          Ending
______________________________________________________________________
Please state your reason for leaving
______________________________________________________________________
Manager/Supervisor Contact Information                           May we Contact?

______________________________________________________________________

REFERENCES: Please provide the name of at least three professional references whom you have
known for at least one year.

#1     Name:                  ____________________________________________________

       Address/Contact:       ____________________________________________________

       Business:              ____________________________________________________

       How do you know this person? ___________________________________________

#2     Name:                  ____________________________________________________

       Address/Contact:       ____________________________________________________

       Business:              ____________________________________________________

       How do you know this person?

#3     Name:                  ____________________________________________________

       Address/Contact:       ____________________________________________________

       Business:              ____________________________________________________

       How do you know this person? ___________________________________________




                                             Page 5 of 6                                 V4.10
                                          AGREEMENT

I hereby authorize Philz Coffee INC. to thoroughly investigate my background, references,
employment record and other matters related to my suitability for employment.

I authorize persons, schools, my current employer (if applicable), and previous employers and
organizations contacted by Philz Coffee INC. to provide any relevant information regarding my
current and/or previous employment and I release all persons, schools, employers of any and all
claims for providing such information.

Understand that misrepresentation or omission of facts may result in rejection of this application,
or if hired, discipline up to and including dismissal.

 I understand that I may be required to sign a confidentiality and/or a non-compete agreement,
should I become an employee of Philz Coffee INC.

I understand nothing contained in this application or conveyed during any interview which may be
granted, is intended to create an employment contract.

I understand filling out this form does not indicate there is a position open and does not obligate
Philz Coffee INC. to hire me.

U.S. APPLICANTS ONLY: I understand and agree that my employment is at will, which means that it is
for no specified period and may be terminated by me or Philz Coffee INC. at any time without prior
notice for any reason.

Signature: ___________________________________________________________

     Date: _____________________________




        Please submit this application to the store nearest you with your resume attached.




                   WE ARE AN EQUAL OPPORTUNITY EMPLOYER
                  COMMITTED TO HIRING A DIVERSE WORKFORCE.



                                      www.philzcoffee.com




OFFICE USE: ________________________________________________________________


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