Team Member Application Team Member Application Which store location are you applying to?(Required)Please select the store you wish to apply toAltoona, WIAmes, IAAmes Mary Greeley Hospital, IAAvon, INBlairsville, GABlue Earth, MNClear Lake, IAColumbia, TNColumbia State College, TNCresco,IAForest City, IAGoshen, INLisbon, IAMason City, IAPapillion, NEPlainfield, INPlainview,MNRice Lake, WIRoasting & Distribution (Clear Lake, Iowa)Savannah, MOSt. Charles, MNStewartville, MNSupport Center (Clear Lake, Iowa)Waterloo, IADate(Required) MM slash DD slash YYYY Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Number(Required)Alternate Phone NumberEmail(Required) Referred byPosition Desired(Required) Full-Time Part-Time Temporary Seasonal Date you can start?(Required) MM slash DD slash YYYY Numbers of hours you would like to work weekly?(Required)What is your availability?Please fill in the hours you are able to work in the day spot. Example: Monday all day, Tuesday afternoons, etc. Monday(Required)Tuesday(Required)Wednesday(Required)Thursday(Required)Friday(Required)Saturday(Required)Sunday(Required)Salary desired(Required)Are you currently employed?(Required) Yes No If so, may we contact your present employer?(Required) Yes No Have you ever applied to this company before?(Required) Yes No Where/When(Required)Are you an U.S. Citizen(Required) Yes No If not, do you have work papers(Required) Yes No Do you know of anyone who is or was employed by Cabin Coffee Co.?(Required) Yes No If so, who?(Required)Is there any work you are unable or unwilling to perform?(Required) Yes No If yes, please explain.(Required)If hired at Cabin Coffee Company, are you prepared to take a physical exam, including a drug and alcohol screening?(Required) Yes No Have you ever been convicted of a crime? (Convictions will not necessarily disqualify an applicant for employment)(Required) Yes No If yes, please explain.(Required)Why do you want to work for Cabin Coffee?(Required)Are you a coffee drinker?(Required) Yes No What is your favorite coffee drink?(Required)Do you have transportation?(Required) Yes No Former EmployersEnter below your last three employers, starting with most recent one first. Date Started (Month and Year)Date Left (Month and Year)EmployerBusiness NameSupervisor's NameStarting SalaryEnding SalaryAddress of Employer City State / Province / Region PhoneStarting position and responsibilitiesEnding position and responsibilitiesReason for leavingMay we contact this employer for references? Yes No Date Started (Month and Year)Date Left (Month and Year)EmployerBusiness NameSupervisor's NameStarting SalaryEnding SalaryAddress City State / Province / Region PhoneStarting position and responsibilitiesEnding position and responsibilitiesReason for leavingMay we contact this employer for references? Yes No Date Started (Month and Year)Date Left (Month and Year)EmployerName of BusinessSupervisor's NameStarting SalaryEnding SalaryAddress City State / Province / Region PhoneReason for leavingMay we contact this employer for references? Yes No Education/Skills/MilitaryWhat is the highest level of schooling you have completed?(Required) Still in High school High School GED Trade School College High School Name(Required)High School Location(Required)Years Attended(Required)Name of Trade School?(Required)Location of Trade School?(Required)Did you graduate?(Required) Yes No Not yet, still in Trade School Subjects studied?(Required)Name of College?(Required)Location of College?(Required)Did you graduate?(Required) Yes No Not yet, still in College Subjects studied/major?(Required)Extra training, skills, etc?U.S. Military or Naval Service?RankResume UploadMax. file size: 2 GB. If you have a resume you would like to add, upload it here. Authorization“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information that may have, personal, or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws” Date(Required) MM slash DD slash YYYY Signature(Required)Please sign if you agree to the above statement
