Tropical Smoothie Job Application Form – Fill Out and Use This PDF

APPLICATION FOR EMPLOYMENT

Tropical Smoothie Café (“TSC”) is an equal opportunity employer and does not discriminate in recruiting, hiring, training, promoting or other employment practices on the basis of race, color, religion, sex, age, marital status, pregnancy, national origin, political affiliation, familial status, disability, sexual orientation or veteran status. No question in this application is intended to obtain information to be used for such discrimination and you may omit any information that would disclose any basis for discrimination.

Please complete this form in your own handwriting and in ink, even if including a resume. We ask that you fill in all information. If you require additional space for answers, please use an additional sheet of paper.

If we are unable to contact you at the address/telephone number listed above, where may you be reached?

Are you 18 years of age or older? Yes No If not, do you have the proper work permits? Yes No

Have you previously been employed with TSC? If yes, when, where, and in what position?

Yes No

Have you previously applied for employment with TSC? If yes, when, where, and in what position?

Yes No

Have you ever been refused bond?

Yes No

If yes, state the reason and date bond was refused.

Job Requirements

Indicate specific position desired

Do you know any reason why you cannot perform the essential functions of the job for which you are applying, with or without

reasonable accommodations?

Yes No

If Yes, please explain

For positions requiring weekend work:

Can you work weekends?	Can you work overtime?
Yes No	Yes No

Tropical Smoothie Cafe

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Education, Training and Skills

School Attended		Name & Location		Major	Degree
High School
Business or Technical School
College
College
Graduate School
Special Training Courses
Do you plan to continue formal education?		Yes No	If Yes, when, where and what courses? _______________________

_________________________________________________________________________________________

List any academic or community activities, honors, and offices that you presently hold or have held in the past. _____________

______________________________________________________________________________________

For positions requiring foreign language:

What language(s) do you speak, read or write? (Indicate languages) ________________________________________

Briefly describe below your interests, skills, and aptitudes that you feel qualify you for a position with TSC. If you need more space, please continue on a separate sheet of paper. ___________________________________________________

______________________________________________________________________________________

Employment Experience

Have you ever been discharged or asked to resign from a position? Yes No If Yes, explain the circumstances. ____________

________________________________________________________________________________________

Have you ever held a position of trust (handling money or confidential material)? Yes No If yes, please specify ___________

______________________________________________________________________________________

Does your present employer know of your plans to change employment? Yes No If not, when may we contact your employer?

______________________________________________________________________________________________

______________________________________________________________________________

Briefly state why you desire to make a change in employment. ____________________________________________________

______________________________________________________________________________________

Please account for all jobs held within the past five (5) years beginning with your present or most recent employer. Include part-time employment, summer or temporary employment and military service (show rank and date of discharge). If necessary, you may attach additional sheets of paper in order to list all prior jobs held. Please continue to list the requested information in the format below. If your

resume is attached, you still need to complete this section thoroughly. Resume attached?					Yes No
Employment Dates	Company Name, Address &	Salary		Position	Supervisors	Reason for Leaving
Month/Year	Phone Number	Start	Final		Name
From		$	$
_____________		Per	Per
To
_____________
Duties:_________________________________________________________________________________________________

Tropical Smoothie Cafe

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Employment Experience (continued)

Employment Dates	Company Name, Address &	Salary		Position	Supervisor’s Name	Reason for Leaving
Month/Year	Phone Number	Start	Final
From		$	$
_____________		Per	Per
To
_____________
Duties:_________________________________________________________________________________________________
Employment Dates	Company Name, Address &	Salary		Position	Supervisor’s Name	Reason for Leaving
Month/Year	Phone Number	Start	Final
From		$	$
_____________		Per	Per
To
_____________
Duties:_________________________________________________________________________________________________

General Information

All Applicants:

(For positions requiring driving):

Do you have a valid driver’s license? Yes No. Has your driver’s license ever been revoked? Yes No. If yes, state date and reason for revocation. _____________________________________________________________________________________

All Applicants EXCEPT Applicants Seeking Employment in California, Colorado, Hawaii, Massachusetts, New Jersey, Ohio and Wisconsin.

Have you been convicted of a felony within the last seven (7) years? Yes No. If yes, please explain. _____________________

__________________________________________________________________________________________________

(Note: Conviction of a felony will not necessarily disqualify you from employment. Factors such as age at the time of offense, date, seriousness and nature of the offense, and rehabilitation will be taken into account.)

Only for Applicants Seeking Employment in California.

Have you ever been convicted of a crime, except for convictions of crimes involving marijuana dating more than two (2) years ago, that was not expunged from your record, and did not result in referral to, or participation in, any pretrial or post-trial diversion program? Yes No. If yes, please explain. ___________________________________________________________

_______________________________________________________________________________________________________

(Note: Conviction of a crime will not necessarily disqualify you from employment. Factors such as age at the time of offense, date, seriousness and nature of the offense, and rehabilitation will be taken into account.)

Are you presently out on bail or your own recognizance pending trial? Yes No. If yes, please explain. ___________________

_______________________________________________________________________________________________________

______________________________________________________________________________________

Only for Applicants Seeking Employment in Florida:

Have you ever been convicted of a crime, excluding minor traffic offenses? Yes No. If yes, state offense, date, court, location, disposition of case, and any rehabilitation._____________________________________________________________________

______________________________________________________________________________________

(Note: Conviction of a crime will not necessarily disqualify you from employment. The above factors will be taken into consideration in determining the effect on your suitability for employment).

Has a court of law ever withheld adjudication for a crime for which you were charged? Yes No. If yes, state offense, date, court, location, disposition of case, and any rehabilitation. ________________________________________________________

______________________________________________________________________________________

(Note: A courts adjudication of guilt being withheld will not necessarily disqualify you from employment. The above factors will be taken into consideration in determining the effect on your suitability for employment).

Tropical Smoothie Cafe

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CERTIFICATION AND AGREEMENT - Please read the following statements carefully before signing. If you have any questions regarding these conditions of employment, please ask them of the employment interviewer before signing.

(A)This application will be given every consideration, but its receipt does not imply that I will be employed.

(B)I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and TSC. In addition, I understand and agree that if I am employed, my employment is for no definite terms or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or TSC, and that no promises or representations contrary to the foregoing are binding on TSC unless made in writing and signed by me and the President of TSC.

(C)I hereby authorize TSC to investigate thoroughly my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to TSC any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release TSC, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

(D)Without limiting my authorization in paragraph (C) above, I hereby specifically authorize and request that my current and all former employers furnish TSC with information about my employment record, including statements of the reason for the termination of my employment, work performance, abilities and other qualities pertinent to my qualifications for employment; hereby releasing them and TSC from all liability and responsibility arising from any information provided.

(E)Should I be employed, I agree to read my Employee Handbook and sign an acknowledgment of receipt and understanding of the Employee Handbook. In addition, I will abide by TSC policies and procedures during my employment, if hired. I fully understand that all information, whether written, spoken or otherwise communicated or obtained, and all files and records relating to the business of TSC or to anyone with whom TSC has dealings, constitute privileged information and are to be treated in a strictly confidential manner. I fully understand and agree that should I be employed, I am not to, and will not at any time, communicate or reveal any business of TSC or any such information, records, files, or the matters contained therein to unauthorized personnel within TSC or to anyone outside TSC. I also understand any violation of the foregoing may result in disciplinary action, including termination of employment.

(F)I fully understand that TSC employs only U.S. citizens and properly authorized aliens, and that should I become employed, federal law requires me to furnish to TSC proof of my identity and employment authorization, and to sign a statement under penalty of perjury verifying my eligibility for employment as a citizen or national of the United States or an otherwise employable alien.

(G)I understand that TSC has a policy against the use, possession or distribution of illegal drugs, including the abuse of alcohol by it employees. I further understand that TSC has a Drug Free Workplace Policy, and understand that violation of this Policy may result in disciplinary action up to and including termination.

(H)I understand that TSC will fully cooperate with any requests by law enforcement agencies for access to employee files and/or information contained in this employment application pursuant to federal, state and/or local laws, including but not limited to the U.S. Patriot Act. Accordingly, I understand that I have no expectations of privacy concerning any information I have provided TSC in this employment application, and/or concerning any information TSC may obtain in connection with this employment application or any future employment relationship I may enter into with TSC. I hereby release TSC from all liability and responsibility arising from any information provided in accordance with applicable federal, state and/or local law.

I CERTIFY THAT ALL STATEMENTS MADE BY ME ON THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND THAT I HAVE WITHHELD NOTHING THAT WOULD, IF DISCLOSED, AFFECT THIS APPLICATION UNFAVORABLY. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE CERTIFICATION AND AGREEMENT STATEMENTS AND UNDERSTAND THE SAME. I UNDERSTAND THAT ANY MISREPRESENTATION OR OMISSION OF FACT IN THIS APPLICATION OR THE HIRING PROCESS WILL BE CAUSE FOR REFUSAL OF EMPLOYMENT OR, IF EMPLOYED, TERMINATION FROM TSC.

Applicant Signature: _______________________________		Date: ___________________
Disposition:	Date of Employment:
	Company:
Date of 1st Interview:	Title:
Date of 2nd Interview:	Salary:	Per:
Interviews Comments:	90-Day Performance Evaluation Date:
	Salary Review Date:
	Approval:

Tropical Smoothie Cafe

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