Coffee Brake Employment Application
Address: 111 E Main St. Evans City, PA 16033 Email:
Email address *
First and Last Name *
Your answer
Phone number *
Your answer
Full-Time or Part-Time? *
Availability (Check all that apply) *
Morning (5am-10am)
Mid-Day (10am-3pm)
Afternoon (3pm-8pm)
When can you start? *
Do you have any coffee shop or other restaurant experience? If yes, please explain. *
Your answer
Other Work Experience *
Your answer
Education *
Please indicate any diplomas/degrees/certifications earned.
Your answer
Have you ever been convicted of a felony?
Additional Information
Use space below if there is anything else you would like to add.
Your answer
Agreement *
Agreement *I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that if I am employed, any misrepresentations, omissions, or false statements on this application will disqualify me from further consideration and may be grounds for immediate dismissal. I authorize investigation of all statements contained in this application. I also grant permission to contact all references listed above, and authorize them to release all information concerning my previous employment and any other pertinent information these references might have, personal or otherwise. I release all parties from all liability for any damage that may result from furnishing this information to you. I understand and agree that, if hired, my employment is for no definite period and no promise is binding unless in writing and signed by the owner. I understand that this application is not an offer, promise, or contract of employment, either expressed or implied. If hired, my employment would be “at will” and could be terminated by either Coffee Brake or me at any time, with or without notice or cause.
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