Name *

First Name

Last Name

Phone

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which Location are you applying to work at? *

Stillwater, MN

St. Paul, MN

Either/Both

Art's Coffee Hut

When can you start? *

MM

DD

YYYY

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? *

Yes

No

When did you/will you graduate High School? *

MM

DD

YYYY

When did you/will you graduate College (if applicable)?

MM

DD

YYYY

Date Started

MM

DD

YYYY

Date Ended

MM

DD

YYYY

Name of Supervisor

First Name

Last Name

Phone Number of Supervisor

(###)

###

####

May we contact above supervisor?

Yes

No

Date Started

MM

DD

YYYY

Date Ended

MM

DD

YYYY

Name of Supervisor

First Name

Last Name

Phone number of Supervisor

(###)

###

####

May we contact above Supervisor?

Yes

No

By checking this box I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history. I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager, or executive of this company, other than the president, has any authority to alter the foregoing. *

I Understand