Circa Coffee Shop Application
Positions available: Barista, Kitchen, Baker
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Which location are you interested in applying? *
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Full Name *
Address *
Date of Birth
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Phone Number *
Email *
Referred by
Position Desired *
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Pay Desired ($____ per hour) *
Date Available to Start
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Weekly Availability 
Please use this example as a guide:
Monday: 2pm — 8pm
Tuesday: OFF (meaning you are unavailable)
Wednesday: 6am — 1pm
Thurs—Sun: ANY (meaning you can work any time)
Unavailable from 4/3/23 — 4/8/23 for vacation.
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Previous Employment (Respond “N/A” if no job is applicable)
Please include the following: 
Company, Job Title, Location Phone Number, Dates of Employment, City and State
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Previous Employment (Respond “N/A” if no job is applicable)
Please include the following: 
Company, Job Title, Location Phone Number, Dates of Employment, City and State
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Previous Employment (Respond “N/A” if no job is applicable)
Please include the following:
Company, Job Title, Location Phone Number, Dates of Employment, City and State
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Education History
High School
Please include: School name, City & State, Graduation Year
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Education History 
College
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Education History
Graduate School
Please include: School name, City & State, Graduation Year
Reference
Please include: full name, occupation, and phone number
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Reference
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Reference
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