Please complete the online Job application

Location Applying for:

Would you like to attach a picture? (jpg, gif or bmp):

First Name:

Middle Initial:

Last Name:

Email:

Street Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Are you 18 Years of Age or older?

yes

Position Applying for:

Salary / Hourly Pay Expected:

Are you willing to Work

	Full Time		Part Time
	Temporary		Weekends
	Evenings

What are your preferred number of hours to work per week?

15-20

21-36

37-40

Please indicate the hours per day you are available below:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

11:00 AM

12:00 PM

1:00 PM

2:00 PM

3:00 PM

4:00 PM

5:00 PM

6:00 PM

7:00 PM

8:00 PM

9:00 PM

10:00 PM

If Hired, when are you available to start Employment?

Have you previously worked for YogaBerry?

Have you ever worked for another Food services company or company in a related business?

Position:		Company:
City/State:		From-To

Are you legally authorized to work in the United States?

Have you ever plead "guilty" or "no contest" to a crime or been convicted?

If yes, give date and details:

Note: Answering yes to the above question does not automatically disqualify you from employment.

Do you have a valid driver's License?

License no:

State:

Has your license ever been suspended?

Why?

Have you ever been convicted of DUI or DWI?

Explain:

List three (3) businesses / work references not related to you and not employed by YogaBerry of Florida, Inc:

Name:	Position:	Phone:
	Company Name:
Name:	Position:	Phone:
	Company Name:
Name:	Position:	Phone:
	Company Name

How did you hear about employment at YogaBerry?

EMPLOYMENT HISTORY (List below last three employers, starting with the most recent one first)

Name of Company:	Salary:	From:	To:
Present or Last Position:		Reason for leaving
Describe Duties
Manager:		Phone:

Name of Company:	Salary:	From:	To:
Present or Last Position:		Reason for leaving
Describe Duties
Manager:		Phone:

Name of Company:	Salary:	From:	To:
Present or Last Position:		Reason for leaving
Describe Duties
Manager:		Phone:

What is the highest grade completed in school?

Are you currently in School?

yes

Do you have experience in?

Payroll Operations	Payroll Accounting	Payroll Taxes	Sales
Payroll Computer Systems	Payroll or Human Resources Field	Customer Service	Office Administration
Finances / Accounting	Timekeeping Administration	Supervision	Benefits Administration
Computer Trouble Shooting	Working in Fast-Paced / Deadline-Driven Environment

Is there any reason why you cannot get to work on time an each day as scheduled?

Explain, if yes:

I understand that if I am hired, my employment will be for no definite period of time. I further understand that I
may terminate my employment at any time and the company has the right to do so at any time.

I understand that the company reserves the right to require me to submit to a drug test at any time before or
during my employment.

I authorize the company to investigate all statements contained in this application for employment as may be
necessary in arriving at an employment decision. I authorize the company to check my driving record, criminal
record, credit history, and other background information, including information on my character and reputation.

I further understand that the company may contact my former employers and I authorize those employers to
disclose all records of my employment with them.

I certify that all information I have provided in this application is true and correct. I understand that should I be
hired and this information is found to be false or misleading, I will be discharged. I understand, also, that should
I be hired that I will be required to abide by all rules and regulations of the employer.

Applicant Name:

Date:

2009