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First Name

Last Name

Phone Number

Address

What position are you applying for? What position are you applying for? Part Time Barista Full Time Barista Part Time Cook Full Time Cook

Which location do you prefer to work at? Which location do you prefer to work at? Sunset Blvd Perks In Washington The Boulevard Drive Thru The Hurricane Drive Thru Perks at Zion Cedar City Drive Thru

Present/Previous Employer

Present/Previous Employer Address

Present/Previous Employer Phone Number

Supervisors Name

Present/Previous Employer Start Date

Present/Previous Employer End Date

Job Title

Present/Previous Job Duties & Responsibilities

Reason For Leaving (If applicable)

Your Education Your Education High School Diploma College Degree Other Degree

Your Availability (Example: Sun-Sat 6am - 8pm)

Reference 1 Name

Reference 1 Phone Number

Relationship to Reference 1

Reference 2 Name

Reference 2 Phone Number

Relationship to Reference 2

Reference 3 Name

Reference 3 Phone

Relationship to Reference 3

If applying for a position that servces alchohol are you 21 or older? If applying for a position that servces alchohol are you 21 or older? Yes No