APPLICATION FOR EMPLOYMENT We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion or national origin.
Please fill in and submit or print out and fax/mail to Fasigs Coffee.

Personal Information
Date:
Last / First Name:
Permanent address:
City:
State:
Zip code:
S.S. Number:
Home Phone:
Referred By:
E-mail address:
Do you drink coffee: Yes  No

Employment Desired
Position:
Date you can start:
Salary Desired:
Are you Employed Now?
Yes   No

If So May We Inquire of Your Present Employer? Yes   No
Ever Applied to this Company Before?
Where?    When?

Education
Grammar School:
Did you graduate Degree:

High School:   Last year completed:
Did you graduate Degree:

College / University:   Last year completed:
Did you graduate Degree:

Business / Trade School:   Last year completed:
Did you graduate Degree:

Subjects of Special Study or Research Work:
Activities Other Than Religious:
(Civic, Athletic, etc.)
EXCLUDE ORGANIZATIONS, THE NAME OR CHARACTER OF WHICH INDICATES THE RACE, AGE, SEX, COLOR OR NATIONAL ORIGIN OF ITS MEMBERS.

Former Employers
List Below Last Four Employers, Starting With Last One First
1.
  • Name
  • Address
  • Supervisor
  • Nature of Business
  • Position Held
  • Dates of Employment
  • Reason for Leaving
  • Salary
    		•

    2.
  • Name
  • Address
  • Supervisor
  • Nature of Business
  • Position Held
  • Dates of Employment
  • Reason for Leaving
  • Salary
    		•

    3.
  • Name
  • Address
  • Supervisor
  • Nature of Business
  • Position Held
  • Dates of Employment
  • Reason for Leaving
  • Salary
    		•

    4.
  • Name
  • Address
  • Supervisor
  • Nature of Business
  • Position Held
  • Dates of Employment
  • Reason for Leaving
  • Salary
    		•

    References
    Please include the names and addresses of three people to whom you are not related and by whom you have known at least One Year.
    1. Name:
    Address:
    Business:
    Yrs. Acquainted:
    		2. Name:
    Address:
    Business:
    Yrs. Acquainted:
    		3. Name:
    Address:
    Business:
    Yrs. Acquainted:


    Physical Record
    Do you have any physical condition which may limit your ability to perform the job applied for?
    This question is voluntary, and any answers will be kept confidential.


    In case of Emergency Notify:
  • Name
  • Address
  • Phone No.
    		•

    I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause of dismissal. Further, I understand and agree that my employment is for no definite period and may, regardless of the data of payment of my wages and salary, be terminated at any time without any previous notice.
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