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Application

First Name | Nombre

Last Name | Apellido

Phone | Telefono

Email

Street Address, Unit # | Direccion, Numero de apartemento

City | Ciudad

State | Estado

Zip | Codigo postal

Birthdate (mm/dd/yyyy) | Cumpleanos

Which Position are your applying for? | ¿A qué puesto te postulas?

Available Start Date (mm/dd/yyyy) | ¿Fecha de inicio?

Expected Weekly Hours: | ¿Cuál es su horario semanal esperado?

Desired Hourly Wage: ¿Cuál es su salario deseado?

Position Applied For: Retail Employee
After reviewing the job description, are you able to perform the essential functions of the position you are applying for with or without a reasonable accommodation? (Including standing for 8+ hour periods of time and occasional lifting up to 50lbs?)

Yes No n/a

Position Applied For: Kitchen Employee
After reviewing the job description, are you able to perform the essential functions of the position you are applying for with or without a reasonable accommodation? (Including standing for 8+ hour periods of time and lifting up to 60 lbs on a daily basis?)

Yes No n/a

How did you hear about us?

How do you keep track of time?

How would you rate your math skills?

Are you able to speak and understand fluent English with ease?

Yes No

Are you able to read and write English proficiently?

Yes No

Do you have any culinary training or or food safety certifications?: Kitchen Employee

Please list culinary programs or certificates:

Are you proficient at using the following: Retail Employee

Square Point of Sale, or other Point of Sale system

Yes No

Do you have cash handling experience?

Yes No

Microsoft WORD for windows

Yes No

Microsoft EXCEL for windows

Yes No

Free Response:

Why do you want to work at The Power of Juice? Do you have a favorite product?

What tools have you used at past jobs to check your work and ensure it is complete, accurate and timely?

When you discover you lack the tools, information or time to complete a task, how do you handle it?

Employment History (Last three years)

Company

Job Title

Dates To - From

Pay Rate

Supervisor

Phone or Email

May we contact this Supervisor for a reference?

Yes No

Reason for Leaving

Other Professional or Character References (Please list three, if not listed in employment history)

DISCLAIMER: The information provided in this Application for Employment is true, correct and complete. If employed, any misstatements or omissions of fact of this application may result in my dismissal. I understand that an acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. I understand that The Power of Juice is an Equal Opportunity Employer. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state or federal law. Equal access to employment, services, and programs is available to all persons.

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