Green Beans Coffee

Employment Application

Green Beans Coffee Company is an equal opportunity employer and does not discriminate, or tolerate discrimination, against any employee or applicant in any manner prohibited by law.

Applicant Information

Education

High School:
Address:
From:
To:
Did you graduate?
1. Yes.
2. No.
Degree:
College:
Address:
From:
To:
Did you graduate?
1. Yes.
2. No.
Degree:
Other:
Address:
From:
To:
Did you graduate?
1. Yes.
2. No.
Degree:

References

Please list three professional references
(1) Fullname:
Relationship:
Company:
Phone:
Address:
(2) Fullname:
Relationship:
Company:
Phone:
Address:
(3) Fullname:
Relationship:
Company:
Phone:
Address:

Previous Employment

Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Salary: $
Ending Salary: $
Responsibilities:
From:
To:
Reason for leaving:
May we contact your previous employer for a reference?
1. Yes.
2. No.
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Salary: $
Ending Salary: $
Responsibilities:
From:
To:
Reason for leaving:
May we contact your previous employer for a reference?
1. Yes.
2. No.
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Salary: $
Ending Salary: $
Responsibilities:
From:
To:
Reason for leaving:
May we contact your previous employer for a reference?
1. Yes.
2. No.

Military Service

Branch:
From:
To:
Rank at discharge:
Training/work experience during military service that may be relevant to position applying for:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature:
Date:

Day	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
From:
To: