Chicka Latte Employment Application Form

Chickalatte Beautiful Coffee, LLC considers applicants for employment without regard to age, sex, marital status, race, creed, color, and national origin, the presence of any sensory, mental, or physical disability or any other reason specified by federal, state and local law. All applications must be complete and accurate to be considered for employment.
Position applied for
Date of application
How did you learn about us?
Referred by
Full Name
Address
City
 StateZip
Telephone, home
Telephone, mobile
Email address
Social Security Number
Can you provide proof of eligibilty of work?
Have you ever been employted with us before?
If yes, please provide dates and position(s)
Are you currently employed
Are you currently subject to recall status by any other employer?
If currently employed, may we contact your current employer?
If no, please explain why
Are you subject to any form of agreement that would restrict your ability to work for this company?
If you are selected for employment with this company, can you provide proof of citizenship or other appropriate documentation to demonstrate your eligibility for employment?
On what date will you be available to commence work?
When are you available to work?
 full time part time weekdays
weeknights weekends
Have you ever been convicted of and/or entered a plea of no contest to a crime?
Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accommodation?
If you require accommodations in order to perform the essential functions of the job for which you are applying, please describe with specificity the type and/or nature of the accommodation requested
Employment Experience
Employment #1
Employer name
Address
City
 StateZip
Office phone
 other phone
Job title
Supervisor
Dates of employment
 to
Hourly wage / or salary
 $
Work performed
Reason for leaving
Employment #2
Employer name
Address
City
 StateZip
Office phone
 other phone
Job title
Supervisor
Dates of employment
 to
Hourly wage / or salary
 $
Work performed
Reason for leaving
Employment #3
Employer name
Address
City
 StateZip
Office phone
 other phone
Job title
Supervisor
Dates of employment
 to
Hourly wage / or salary
 $
Work performed
Reason for leaving
Employment #4
Employer name
Address
City
 StateZip
Office phone
 other phone
Job title
Supervisor
Dates of employment
 to
Hourly wage / or salary
 $
Work performed
Reason for leaving
Education and Training
High school
 (name & address)
Dates attended
 to
Grade completed
Type / name of degree
College
 (name & address)
Dates attended
 to
Grade completed
Type / name of degree
Graduate school
 (name & address)
Dates attended
 to
Grade completed
Type / name of degree
Please list any academic achievements, honors activities, certifications or other information that may be helpful in considering your employment application:
Applicant's Statement:
I certify that the answers given in this application are true and complete to the best of my knowledge and are subject to verification by the company. I understand that false and/or misleading information or any material omission or misrepresentation given in my application or interview(s) may result in refusal to hire and/or discharge. I understand that I am required to abide by all rules and regulations of the employer.

I understand that while management will make effort to accommodate individual preferences, business needs may require that I work overtime, change shifts, work a rotating schedule or make other changes which are necessary to accommodate legitimate business needs. I understand and accept that these are continuing conditions of my employment if I am employed.

I understand that I am being employed as an “at will” employee. I understand that being an “at will” employee means that either the company or I can terminate my employment at any time with or without cause and with or without prior notice. I understand that no promises of specific treatment in any specific circumstance is being made to me and that no promise is valid unless that promise is in writing and signed by the president of the company. I understand that nothing contained in this application or in the granting of an interview for a position with the company is intended to or creates a contract between the company and me.

I understand and agree that I may be required to submit to medical examinations, blood tests and/or drug screenings as a condition of my employment and/or continued employment. I agree to take such tests and I release the Company and any of its officers, directors, agents and employees from any liability arising out of this requirement or the use of any information obtained from such tests.

I understand and agree that honesty, integrity, fulfillment of commitments and responsibilities are core values of and necessary traits for employment at the Company. I also understand and agree that these traits are substantially related to the job for which I am applying or in which I am to be employed. As such, I understand and agree that the company will run a credit history report on me and may make decisions regarding my employment based upon that information. I understand that the company will provide me with written notice if any decisions regarding my employment are made based upon my credit history.

I understand and agree that if I am employed by Chickalatte Beautiful Coffee Inc., and if I terminate my employment with the Company while owing the company any money, that money may be withheld from my final paycheck.

In order to foster health and safety in the work place, I understand and agree that smoking in the work place, near work facilities or during business hours when I am on duty is prohibited and that violation of this policy can be grounds for termination.

I understand and agree that as a part of my employment, I will be provided a set number of uniforms for use while employed with the company. I agree that should I fail to return the uniform in good condition to cessation of my employment, the Company may deduct the cost of the uniform from my final pay check.

I understand that the business of Chickalatte Beautiful Coffee Inc. is built upon the concept that “Our Image is Our Business” and as such, vivacious, attractive, engaging, sincere and quality women who assume the roles demonstrated by the costumes they wear will make both the sales of our products and your careers successful. Therefore, I agree that if I am selected to play a role for the Company, I will comply with all appearance, image and grooming standards established by the company.
Statement agreement:
 I agree to the above: noyes
Applicant's name
Date application submitted:
notes or additional information: