I am able to converse independently in English *

YES

NO

I am able to stand up to 8 hours straight *

YES

NO

I am able to lift 50 lbs. *

YES

NO

I am able to work independently on a given task *

YES

NO

I am able to work as part of a team *

YES

NO

I am able to be gainfully employed upon graduation from the program *

YES

NO

Are you ready to apply? *

Yes, I'm all in!

No, it's not for me.

I am applying for a employment training position at: *

Freedom Blend Coffee

Freedom Construction Services

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Gender

Male

Female

Present Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Diploma or Hiset Earned? *

Yes

No

Have you ever been convicted of a crime? *

Yes

No

Do you have reliable transportation? *

Yes

No

Are you able to work Monday through Friday (FCS) or Monday through Saturday (FBC)? *

Yes

No

Are you able to work as early as 8:00 am (FCS) or 6:00 am (FBC) and as late as 5:00 pm? *

Yes

No

Application Waiver - Please Read Carefully

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of any employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Freedom Blend Coffee or Freedom Construction Services, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship at any time without specified notice or reason. If employed, I understand the Company may unilaterally change or revise their benefits, policies, and procedures and such changes may include reduction in benefits.

I agree

I do not agree

Permission to Contact *

I authorize investigations of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references and others, and hereby release the Company from any liability as a result of such contact. I understand that a drug test may be required for employment consideration.

I agree

I do not agree

Criminal History Background Check *

I understand, in connection with the routine processing of this employment application, the Company may request a criminal background check including past criminal convictions and driving records. Upon written request from me, the Company will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the fair Credit Reporting Act.

I agree

I do not agree

Signature

The information on this application is correct to the best of my knowledge.

I agree

I do not agree

Name

First Name

Last Name

Today's Date

MM

DD

YYYY