Tierra Mia Application – Fill Out and Use This PDF

APPLICATION FOR EMPLOYMENT

TIERRA MIA COFFEE COMPANY IS AN EQUAL OPPORTUNITY EMPLOYER COMMITTED TO NON-DISCRIMINATION AND DIVERSITY.

(PLEASE PRINT CLEARLY AND ANSWER ALL QUESTIONS)

PERSONAL INFORMATION

Name (last, first, middle): ____________________________________________ Social Security Number:_____________________

Address (street, city, state, zip): _________________________________________________________________________________

Cell phone: __________________ Home phone: ___________________ Email: __________________________________________

__________________________________________________________________________________________________________

(Note: You need not identify convictions that have been sealed, expunged, dismissed, or otherwise eradicated by statute or court order, any conviction for a marijuana offense if the conviction is more than two years old. A conviction will not necessarily prevent you from obtaining employment.)

Position applying for: ____________________ How did you learn about the position?: _________________________________

AVAILABILITY

Please list the times that you are available to work on each day (For example: 6AM – 12PM, 12PM – 5PM, 5PM – 12AM):

How long would you like to work for Tierra Mia Coffee Company?: 8-12 Months ____ 1 year or more ____ 2 years or more ____

EDUCATION

EXTRA-CURRICULAR ACTIVITIES

WORK EXPERIENCE

Please start with most your recent job, listing paid or relevant non-paid positions.

REFERENCES

Please provide the names and contact information for three professional references.

ADDITIONAL INFORMATION

Provide 3 reasons why you want to work for Tierra Mia Coffee Company! ______________________________________________

____________________________________________________________________________

How often do you drink coffee? What are your 2 favorite coffee beverages? _____________________________________________

Do you speak any foreign languages fluently or near fluently? Please explain. ___________________________________________

What makes you a good candidate for Tierra Mia Coffee? ____________________________________________________________

I declare that the information given in this application is true and complete to the best of my knowledge. I understand that false or misleading information provided in my application or interview(s) may result in my not being hired, or if hired, in my termination of employment. I hereby authorize Tierra Mia Coffee Company to investigate information and statements contained in this Application For Employment, and I hereby release any present employers and past employers from all liability and damages arising from any and all information they may provide regarding my employment with them. I understand nothing contained in this application or any subsequent interviews is intended to create an employment contract. I understand that if I am hired by Tierra Mia Coffee Company, my employment will be at will, meaning that it is not for a specific period and may be terminated by either me or Tierra Mia Coffee Company at any time without any reason or advance notice.