Employment Application

Your Name (required)

Your Email (required)

Upload your completed application

2. Or fill out the application form below

Personal Information

Your Name (required)

Your Email (required)

Date (required)

Present Address (required)

Permanent Address:

Telephone (required)

Cell Phone

Employment Desired

Position

Office/Store Location

Date Available

Desired Wage

Availability
Full TimePart Time

Have you ever been previously employed with Java Detour?
YesNo

Dates of any previous employment with Java Detour

Have you ever applied for a position at Java Detour before?
YesNo

Position applied for

Office/Store Location

Do you have any relatives who work for Java Detour?
YesNo

If yes, name of person & relationship to you

Do you possess a valid California Driver’s License?
YesNo

How did you first learn about this position?

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?
YesNo

If no, describe the functions that cannot be performed

(Note: We comply with the ADA and California Fair Employment and Housing Act and consider reasonable accommodation measures that may be necessary for eligible applicants /

employees to perform essential functions.)

Have you ever been convicted of a criminal offense (felony or serious misdemeanor)?
(Convictions for marijuana-related offenses that are more than two years old need not be listed)
YesNo

If yes, state the nature of the charge, the court and county, the date of the conviction, and the disposition of the case

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, date of the offense, the surrounding circumstances,

and the relevance of the offense to the position (s) applied for may however, be considered.)

Computer Skills (Please check those that you are proficient in)
WordExcelPowerPointOutlook

Can you, after offer of employment, submit verification of your legal right to work in the United States?
YesNo

Are you able to meet the attendance requirements of the position?
YesNo

EDUCATION (Include Trade/Business Correspondence School)

High School Check the highest grade completed
9101112
Graduated?
YesNo
Name of High School & Location (City, State)

College or University check the highest grade completed
1234
Graduated?
YesNo
Name of School & Location (City, State) Please include major and degree earned

Name of School & Location (City, State) Please include major and degree earned

Trade, Vocational, Business Correspondence School & Location (City ,State)

SPECIAL SKILLS AND/OR CERTIFICATIONS

Type of Skill/Certification

FORMER EMPLOYMENT List your most recent employment first.
1. Employer Name Address and and Phone Number

Immediate Supervisor & Title and Phone Number

Your Job Title and Dates Employed

Responsibilities

Reason for Leaving and Salary

2. Employer Name Address and and Phone Number

Immediate Supervisor & Title and Phone Number

Your Job Title and Dates Employed

Responsibilities

Reason for Leaving and Salary

3. Employer Name Address and and Phone Number

Immediate Supervisor & Title and Phone Number

Your Job Title and Dates Employed

Responsibilities

I understand and agree that if Java Detour employs me, I will abide by its rules and regulations, including those set forth in the Java Detour Employee Handbook as may be amended from time to time.
Please Initial (required)

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and Java Detour. In addition, I understand and agree that if I am employed, my employment is at-will and for no definite and determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or Java Detour and that no promises or representations contrary to the foregoing are binding on Java Detour unless made in writing and signed by me and the designated representative at Java Detour.
Please Initial (required)

I hereby certify that all information contained in the application, and the resume I have submitted to Java Detour, if any, is true and correct, and I authorize Java Detour to contact any of my schools, former employers or other references, unless otherwise stated. I understand that if I am employed, any omission or misrepresentation of the facts stated or implied in this application or my resume is grounds for immediate termination. This determination is solely at Java Detour’s discretion.
Please Initial (required)

Applicant Signature and Date (required)

Additional Comments

Please fill in the characters below (required)