Cafe Gratitude KC Employment Interest Form
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Email *
Preferred Name *
Preferred Gender Pronoun
Legal Name *
Phone Number *
Mailing Address *
How long have you lived there (Years/Months)
If under the age of 18 can you produce the necessary work certificate at the time of employment?
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Type of employment desired?
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Are you willing to work overtime?
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Date on which you can start if hired.
Have you ever plead guilty or no contest to, or been convicted of any criminal offense? (Do not include convictions that were sealed eradicated, annulled by a court, or expunged, or convictions that resulted in referral to a diversion program)
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Have you ever been arrested for any matters for which you are currently out on bail or on your own recognizance pending trial?
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Please list degree of education i.e. High School, College. Include degrees earned.
Work experience ( Please list last 3 places of employment, and include number of years/months worked at each)
Please explain all gaps in your employment history greater than one month.
Please give three professional references (Name position, company, work relationship, telephone)
Please give two personal references (Name, relationship, number of years known, telephone)
I certify that all information I have provided on this application is accurate, true and complete.
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What positions are you interested in? Check all that apply *
Regarding the positions you are interested in, please list any experience you have in any of the positions you have put a checkmark next to. If you have no experience please indicate that. (that is okay we are happy to train people if you are motivated to learn) For example: "Server - No experience, Line - Cooked at XYZ for 1 year" *
Have you worked at Cafe Gratitude Before? *
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