Name *

First Name

Last Name

Phone *

(###)

###

####

Date Available *

MM

DD

YYYY

Check the one that applies *

Seasonal work

Part time work

Full time work

We are currently looking for employees to work a MINIMUM of 24 hours a week (3 days) and up to full time. Are you willing and able to work a minimum of 3 days a week? *

Yes

No

Currently Employed *

Yes

No

Other commitments that may change availability? *

Choose at least one

No

Job

School

Other

How many hours a week do you prefer to work? *

30-40 hours (avg 4-5 days a week)

24-30 hours (avg 3-4 days a week)

less than 24 hours/week

Which days of the week are you available to work? *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

What are you preferred working times? If you have no preference, select all

Opening Shift (begins at 6:30am)

Mid Shift

Closing Shift (off at 6:00pm)

Are you willing to work all weekend? and of course holiday, if needed? *

Weekends

Holidays

Are you legally eligible to work in the US? *

yes

no

If you are under 18, can you furnish a work permit as required? *

Yes

No

Not applicable

Preferred Transportation *

Drive

Bike

Walk

Public Transit

Other

ACKNOWLEDGEMENT: By checking this box I certify that the information contained in this application is correct to the best of my knowledge. I authorize any person, organization or company listed on this application to furnish Pink Owl Coffee, Inc. any and all information concerning my previous employment, education and qualifications for employment. I also authorize Pink Owl Coffee Inc. to request and receive such information. *

Yes, I agree to the above statement