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Acoustic Café
Contact Information
Name
*
First
Middle
Last
Email
*
Present Address
*
Street Address
City
State
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Vermont
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Washington
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Wisconsin
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone Number
*
Permanent Address
*
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone Number
*
How did you learn of this job?
Newspaper
Sign
Friend
Other
Please explain other
Names of friends or relatives employed at Acoustic Café
If applying for temporary work, when would you terminate
Personal Information
Are You 18 years Of Age?
*
Yes
No
If under 18 years, give date of birth
*
Do you have another job which will continue if employed at Acoustic Café?
*
Yes
No
Do you have any limitations that might prevent you from performing your job?
*
Yes
No
Are you legally authorized to work in the US
*
If hired, proof of authorization will be required
Yes
No
Person to contact in case of emergency
Emergency Contact Name
*
First
Last
Emergency Contact Address
*
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Emergency Contact Phone
*
EDUCATION
Education History - List High School and any post High School education. Click the + button on the far right to add additional high schools, colleges, universities, technical colleges, or trade schools
Click the + button on the far right to add additional high schools, colleges, universities, technical colleges, or trade schools
Name & Location of School
Currently Attending?
Courses of Study
Highest Grade Or Year Completed
Degree Earned
School Activities, Special Accomplishments, Special Knowledge, Skills & Abilities
Employer History - Most Recent
List all you employers for the last 10 years. You may list additional jobs if you believe that they relate to your qualification for this position. Begin with most recent job first.
1. Last or Present Job
Company
Address
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone Number
Employed From
(mm/yyyy)
Employed To
(mm/yyyy)
Position Held
Describe Duties
Starting Salary
Ending Salary
Name & Title of Supervisor
Reason for Leaving
May We Contact Employer?
Yes
No
2. Next to Last Position
Company
Address
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone Number
Employed From
(mm/yyyy)
Employed To
(mm/yyyy)
Position Held
Describe Duties
Starting Salary
Ending Salary
Name & Title of Supervisor
Reason for Leaving
May We Contact Employer?
Yes
No
3. Second from Last Position
Company
Address
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone Number
Employed From
(mm/yyyy)
Employed To
(mm/yyyy)
Position Held
Describe Duties
Starting Salary
Ending Salary
Name & Title of Supervisor
Reason for Leaving
May We Contact Employer?
Yes
No
4. Third from Last Position
Company
Address
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone Number
Employed From
(mm/yyyy)
Employed To
(mm/yyyy)
Position Held
Describe Duties
Starting Salary
Ending Salary
Name & Title of Supervisor
Reason for Leaving
May We Contact Employer?
Yes
No
Explain Any Period Between Jobs
Position you are applying for
*
Can you work full time or part time?
*
Full Time
Part time
Hours/Week desired
What days of the week and hours are you available to work?
Indicate Day and Night hours
Mon
Tues
Wed
Thurs
Fri
Sat
Sun
Please attach you class schedule if applicable
Accepted file types: jpg, gif, png, pdf, word, Max. file size: 64 MB.
PERSONAL OR BUSINESS REFERENCES
Add 2 References
*
Click the + button on the right to add additional references
Name
Phone Number
How Known
Why do you feel you in particular should be considered for a position at Acoustic Café?
*
List 3 personal goals you are presently working toward
*
Resume
If you have an electronic version (Word, PDF, etc.) of your resume, you may attach it here.
Accepted file types: doc, docx, pdf, jpg, gif, png, Max. file size: 64 MB.
NOTIFICATION AND AGREEMENT
Applicant Statement
I hereby authorized Acoustic Cafe to investigate all statements contained in this application and agree to hold Acoustic Cafe harmless in this regard.
I understand that misrepresentation or omission of material facts will be considered cause for discharge.
I also understand that employment with Acoustic Cafe is governed by the Doctrine of Employment at Will.
Signature (Type your initials)
DO NOT SUBMIT UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT
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