Application For Employment (Page 2 of 2) in pdf

List below current and last three employers, starting with most recent one first. Please include any non-paid/volunteer

FORMER EMPLOYERS

experience which is related to the job for which you are applying. Please complete even if you attach a resume.

Date (M/D/Y)

Current Employer (Name and Address of Employer - Type of Business)

Salary Or Hourly

Position

Reason For Leaving

From

Starting __________________

Ending __________________

If hourly, average #

of hours per week __________

Duties Performed

Supervisor's Name

Phone Number

May We Contact?

Previous Employer (Name and Address of Employer - Type of

Salary Or Hourly

Position

Reason For Leaving

From

Business)

Starting __________________

Ending __________________

If hourly, average #

of hours per week __________

Duties Performed

Supervisor's Name

Phone Number

May We Contact?

Previous Employer (Name and Address of Employer - Type of

Salary Or Hourly

Position

Reason For Leaving

From

Business)

Starting __________________

Ending __________________

If hourly, average #

of hours per week __________

Duties Performed

Supervisor's Name

Phone Number

May We Contact?

Previous Employer (Name and Address of Employer - Type of

Salary Or Hourly

Position

Reason For Leaving

From

Business)

Starting __________________

Ending __________________

If hourly, average #

of hours per week __________

Duties Performed

Supervisor's Name

Phone Number

May We Contact?

REFERENCES

Give below the names of three professional references, whom you have known at least one year.

Years Acquainted

How Do You Know

Name

Address & Phone Number

Business

This Person?

I hereby authorize Starbucks to thoroughly investigate my background, references, employment record and other matters related to my suitability for employment.

I authorize persons, schools, my current employer (if applicable), and previous employers and organizations contacted by Starbucks to provide any relevant

information regarding my current and/or previous employment and I release all persons, schools, employers of any and all claims for providing such information. I

understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up to and including dismissal. I understand

that I may be required to sign a confidentiality and/or non-compete agreement, should I become an employee of Starbucks Coffee Company. I understand that

nothing contained in this application, or conveyed during any interview which may be granted, is intended to create an employment contract. I understand that

filling out this form does not indicate there is a position open and does not obligate Starbucks to hire me. (U.S. APPLICANTS ONLY: I understand and agree that

my employment is at will, which means that it is for no specified period and may be terminated by me or Starbucks at any time without prior notice for any reason.

MARYLAND APPLICANTS ONLY: Under Maryland law, an employer may not require or demand, as a condition of employment, prospective employment, or

continued employment, that an individual submit to or take, a lie detector or similar test. An employer who violates this law is guilty of misdemeanor and subject to

a fine not exceeding $100. MASSACHUSETTS APPLICANTS ONLY: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of

employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. CALIFORNIA APPLICANTS ONLY:

Applicant may omit any convictions for the possession of marijuana (except for convictions for the possessions of marijuana on school grounds or possession of

concentrated cannabis) that are more than two(2) years old, and any information concerning a referral to, and participation in, any pretrial or post trial diversion

program.

Date________________________________________Signature ________________________________________________________

For Retail positions please submit this application at your nearest

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

store location. For non-retail openings, please visit our website at

COMMITTED TO HIRING A DIVERSE WORKFORCE.

to apply for any posted position.

PRINTED ON RECYCLED PAPER