Alterra Coffee Employment Application
Personal Information:
Todays Date:
Your Full Name:
Social Security Number:
Current Address:
Email Address:
City, State:
Zip:
Phone:
Referred By:
Are you
under
18 years old?
Yes:
No:
Are you legally eligible for employment in the United States?
Yes:
No:
Employment Desired:
Position:
Location:
Salary/Wage:
Date you can Start:
Have you applied with us before?:
Where and When:
Availability:
Part-Time
Full-Time
M:
Tu:
W:
Th:
F:
Sa:
Su:
Education:
High School:
Years Attended:
Did you graduate?
Yes:
College:
Years Attended:
Did you graduate?
Yes:
Main fields of study/degree:
Post Graduate:
Years Attended:
Did you graduate?
Yes:
Main fields of study/degree:
Business or Trade School:
Years Atteneded:
Did you graduate?
Yes:
Main fields of study/degree:
Special study/training/skills:
US Military/Naval Service and Rank:
Skills relevant to desired position:
Computer Proficiency (Word, Excel, Access, etc...):
Former Employers:
please list current/most recent employer first.
Employer:
Address:
Phone #:
Position:
Wage:
Type of Business:
Start/End Date:
Reason for Leaving:
Duties Performed:
Supervisor:
Employer:
Address:
Phone #:
Position:
Wage:
Type of Business:
Start/End Date:
Reason for Leaving:
Duties Performed:
Supervisor:
Employer:
Address:
Phone #:
Position:
Wage:
Type of Business:
Start/End Date:
Reason for Leaving:
Duties Performed:
Supervisor:
References:
List the names of three professional references whom you have known for at least 1 year.
Name:
City,St:
Phone:
Business:
Relation to you:
Years known:
Name:
City,St:
Phone:
Business:
Relation to you:
Years known:
Name:
City,St:
Phone:
Business:
Relation to you:
Years known:
Additional Information:
What do you like about coffee/tea?
Why would you like to work for Alterra?
Describe your best customer service experience:
Anything else you would like to tell us?
Authorization:
Please read below and check the box if agreed.
I agree:
"I certify that the facts contained in this application are true and complete to the best of my knowledge, and understand that falsification of these statements is grounds for dismissal. I authorize Alterra Coffee to confirm all statements made in this application and to contact previous employers and personal references."
