ZÜ COFFEE EMPLOYMENT APPLICATION

Zu Coffee Company is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion, national origin, the presence of mental, physical, or sensory disability, or any other basis prohibited by federal, state, or provincial law.

Please send (or drop off) the completed application to Zu Coffee, 934 Bay Ridge Road, Annapolis, MD 21403.

PERSONAL INFORMATION (please print)            
Name Last First  Middle  Date (m/d/y)
                   
  Have you been convicted of a crime in the yes
Social Security Number last seven years? If yes, please explain. no
     
Upon employment, can you show verification yes Are you at least 18 years of age?   yes
of your legal right to work in the US? no         no
Street Address       City, State   Zip Code    
                   
Phone Number Daytime/Cell   Evening/Home      
                   
 
EMPLOYMENT DESIRED                
Position Desired     Salary Desired   Date You Can Start  
                   
      Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Specify hours available for each day:        
                   
Are you able to work overtime?     Hours desired per week:    
EDUCATION                  
  Years Completed
  Name and Address of School Major Course of Study Diploma/Degree
High School              
           
College          
           
Trade, Business, or            
Technical School        
List skills relevant to position applied for:            
Why would you like to work for Zu Coffee?               
                   
                   
What do you like about coffee?               
                   
                   
Do you have any special skills or talents?                
                   
                   
                   
FORMER EMPLOYERS   List below current and previous employers, starting with the most recent one first.
Date (M/D/Y)                  
   From Current Employer (Name and Address of Employer) Salary or Hourly   Position Reason for Leaving
      Starting______________      
      Ending_______________      
   To     Average# of hours      
          per week _____________      
Duties Performed                
                   
Supervisor's Name       Phone Number May We Contact?  
                   
   From Current Employer (Name and Address of Employer) Salary or Hourly   Position Reason for Leaving
      Starting______________      
      Ending_______________      
   To     Average# of hours      
          per week _____________      
Duties Performed                
                   
Supervisor's Name       Phone Number May We Contact?  
                   
   From Current Employer (Name and Address of Employer) Salary or Hourly   Position Reason for Leaving
      Starting______________      
      Ending_______________      
   To     Average# of hours      
          per week _____________      
Duties Performed                
                   
Supervisor's Name       Phone Number May We Contact?  
                   
   From Current Employer (Name and Address of Employer) Salary or Hourly   Position Reason for Leaving
      Starting______________      
      Ending_______________      
   To     Average# of hours      
          per week _____________      
Duties Performed                
                   
Supervisor's Name       Phone Number May We Contact?  
                   
REFERENCES Give the names of three personal or professional references, whom you have known at least one year.
   
  Years Acquainted
  How do you know this person?
Name Address & Phone Number Business
1                  
2                  
3                  
                   
The information I have provided on this application is accurate and true to the best of my knowledge.  I hereby authorize Zu Coffee to thoroughly investigate my background, references, employment record and other matters related to my suitability for employment.  I authorize persons, schools, my current employer, and previous employers and organizations contacted by Zu Coffee to provide any relevant information regarding my current and/or previous employment.  I release all persons, schools, employers of any and all claims for providing such information.  I understand the misrepresentation or omission of facts may result in rejection of this application, or, if hired, discipline up to and including dismissal. 
 I understand that filling out this form does not indicate there is a position open and does not obligate Zu Coffee to hire me.  I understand that nothing contained in this application, or conveyed during any interview which may be granted, is intended to create an employment contract.  I understand that I may be required to sign a confidentiality and/or non-compete agreement, should I become an employee of Zu Coffee Company.  I understand and agree that my employment is at will, which means that it is for no specified period and may be terminated by me or Zu Coffee at any time without prior notice for any reason.
   
Date  _____________________ Signature  ____________________________________