Mcleods Employment Application

Date *

Resume Upload

Click or drag a file to this area to upload.

legal Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Home Phone

Mobile Phone *

Are you eligible to work in the U.S? *

Are you at least 18 years or older? *

(If no, you may be required to provide authorization to work)

Have you ever been terminated from employment or asked to resign by an employer? *

(If no, you may be required to provide authorization to work)

If yes, please provide company names and details

What is your availability? *

(Put a check mark in the boxes you're available).

Date you can start *

Hourly Rate/Salary desired *

Position desired *

(check all that apply).

Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation? *

Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for? *

Are you currently employed? *

If yes, may we inquire of your present employer?

Have you ever worked for this company before? *

Explain

Education

What kind of Education? *

Name & Location of School *

# of Years Attended *

Degree Received *

Subjects Studied / Major *

Employment History

Please include your last two (2) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

Employer Name *

First

Last

Starting Date *

Ending Date *

Job Title *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Immediate Supervisor & Title *

Summarize the nature of work performed and job responsibilities *

Reason for leaving *

Employment History (2)

Employer Name *

First

Last

Starting Date *

Ending Date *

Job Title *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Immediate Supervisor & Title *

Summarize the nature of work performed and job responsibilities *

Reason for leaving *

References *

Give the names of three persons not related to you, whom you have known at least three (3) years.

Please read carefully before signing.

McLeod’s Coffee House is an equal opportunity employer. McLeod’s Coffee House does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service. I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for McLeod’s Coffee House to hire me. If I am hired, I understand that either McLeod’s Coffee House or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of McLeod’s Coffee House has the authority to make any assurance to the contrary. I attest with my signature below that I have given to McLeod’s Coffee House true and complete information on this application. No requested information has been concealed. I authorize McLeod’s Coffee House to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Date / Time *

Date

Time

Signature *

This application is valid only for 60 days from the date signed/dated above.