Employment Application

Name*
FirstLast
Email*
Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone*
Alternate Phone
Desired Position*
- Barista
Shop Preference*
Shop Preference Alternate
Please check the following where applicable:
- I am currently employed
- I am 16+ years of age
- I am legally eligible to work in the United States
- I can perform the essential functions of this job (with or without reasonable accomodation)
- I have been employed by Saxbys before
Have you ever been convicted of a felony?*
If yes, please explain:
Have you ever been fired or asked to resign from a job?*
If yes, please explain:
How did you hear about Saxbys?
Newspaper Ad, Current Employee (include name), etc...
Are you related to any current Saxbys employees?*
If yes, what is their name and relation?
Availability
I am available starting on:*
My availability is as follows:*
Please list out Monday through Sunday and specify times per day.
High School Education
High School Name
Location
Study
Years
Diploma
College Education
College Name
Location
Study
Years
Diploma
Post College
Name
Location
Study
Years
Diploma
Employment History
Begin with current or most recent employer. Do not exclude any employment. Include any applicable temporary employment if necessary. Previous salaries or wages will not be used to determine compensation at Saxbys stores.
Company 1
Company Name:
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone
Start Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Starting Salary
Ending Salary
Supervisor Name:
Supervisor Title
Duties Included:
Reason for Leaving and Explanation:
Company 2
Company Name:
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone
Start Date:
MM
DD
YYYY
End Date:
MM
DD
YYYY
Starting Salary:
Ending Salary:
Supervisor Name:
Supervisor Title:
Duties Included:
Reason for Leaving and Explanation:
Company 3
Company Name:
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone
Start Date:
MM
DD
YYYY
End Date:
MM
DD
YYYY
Starting Salary:
Ending Salary:
Supervisor Name:
Supervisor Title:
Duties Included:
Reason for Leaving and Explanation:
References
Please list three persons, who are not related to you or previous supervisors, who can provide professional references.
Reference 1
Reference Name*
Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone*
Occupation*
Years Known:*
Reference 2
Reference Name
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone
Occupation
Years Known:
Reference 3
Reference Name
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone
Occupation
Years Known:*
Why do you want to work for Saxbys?*

Employment Application

Availability

High School Education

College Education

Post College

Employment History

Company 1

Company 2

Company 3

References

Reference 1

Reference 2

Reference 3