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40018703_232826060725569_627435197993844

COFFEE & COCKTAILS AT 76067

(940) 226-8700

100 S. Oak Ave. Mineral Wells TX, 76067

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Job Application

Please complete the form to apply for a position with us.

First Name

Email Address

Are you either a citizen of the U.S. or an alien authorized to work in the U.S.?

Yes

No

Available Start Date

Last Name

Phone

Have you ever been convicted of a crime other than a minor traffic violation?

Yes

No

Position Applying For

Date of Birth

Address

If Yes, please explain

Pay Rate Desired?

Hours Per Week Desired?

Did you graduate High School?

Yes

No

Days & Hours Available?

What High School did you attend?

Did you graduate College?

Yes

No

What college did you attend? Wht was your course of study?

Other education, training, or special skills?

Employer Name & Address

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To

Position Held

Reason For Leaving?

Supervisor Name & Title

May We Contact?

Yes

No

Description of Duties

Starting Pay

Ending Pay

Employer Name & Address

From

To

Position Held

Reason For Leaving?

Supervisor Name & Title

Starting Pay

Ending Pay

May We Contact?

Yes

No

Description of Duties

Employer Name & Address

From

To

Position Held

Supervisor Name & Title

Starting Pay

Ending Pay

Reason For Leaving?

May We Contact?

Yes

No

Description of Duties

Reference: Name, Phone Number, Position, Years Known?

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