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± Tropical Smoothie Cafe Page 1 of 4 9/09 APPLICATION FOR EMPLOYMENT Tropical Smoothie Café (“TSC”) is an equal opportunity employer and does not discriminate in recruiting, hiring, training, promoting or other employment practices on the basis of race, color, religion, sex, age, marital status, pregnancy, national origin, political affiliation, familial status, disability, sexual orientation or veteran status. No question in this application is intended to obtain information to be used for such discrimination and you may omit any information that would disclose any basis for discrimination. Please complete this form in your own handwriting and in ink, even if including a resume. We ask that you fill in all information. If you require additional space for answers, please use an additional sheet of paper. Personal Information Last Name First Name MI Social Security Number Telephone Number E-Mail Street Address City State Zip If we are unable to contact you at the address/telephone number listed above, where may you be reached? Address Telephone Number Are you 18 years of age or older? Yes No If not, do you have the proper work permits? Yes No Have you previously been employed with TSC? If yes, when, where, and in what position? Yes No Have you previously applied for employment with TSC? If yes, when, where, and in what position? Yes No Have you ever been refused bond? Yes No If yes, state the reason and date bond was refused. Job Requirements Indicate specific position desired Do you know any reason why you cannot perform the essential functions of the job for which you are applying, with or without reasonable accommodations? Yes No If Yes, please explain Can you work the regular hours/days/shifts of the job for which you are applying? Salary Sought For positions requiring weekend work: Can you work weekends? Yes No Can you work overtime? Yes No Check appropriate employment desired: ± Full Time ± Part Time ± Temporary What date would you be available to begin work?
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± Tropical Smoothie Cafe Page 2 of 4 9/09 Education, Training and Skills School Attended Name & Location Major Degree High School Business or Technical School College College Graduate School Special Training Courses Do you plan to continue formal education? Yes No If Yes, when, where and what courses? _______________________ _________________________________________________________________________________________ List any academic or community activities, honors, and offices that you presently hold or have held in the past. _____________ ______________________________________________________________________________________ For positions requiring foreign language: What language(s) do you speak, read or write? (Indicate languages) ________________________________________ Briefly describe below your interests, skills, and aptitudes that you feel qualify you for a position with TSC. If you need more space, please continue on a separate sheet of paper. ___________________________________________________ ______________________________________________________________________________________ Employment Experience Have you ever been discharged or asked to resign from a position? Yes No If Yes, explain the circumstances. ____________ ________________________________________________________________________________________ Have you ever held a position of trust (handling money or confidential material)?
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