Xtreme Juice Job Application

So you'd like to experience XJ from the other side of the counter? Sweet! We're thrilled that you're interested in joining the team. If you've got plenty of energy, a love of all things Xtreme and a tounge for the freshest smoothies, you're sure to make a great addition.

Personal Information

Full Name	Email Address

Current Address

City	State	Zip

Permanent Address

City	State	Zip

Phone	Cell

Are You Currently Employed?	May We Contact Your Employer?
YES NO	YES NO

Date Available to Start	Referred By	Favorite Xtreme Juice Smoothie

Have You Applied with XJ Before?	How Many Hours Would You Like to Work?	Expected Rate
YES NO

Are you at least 16 years old?	Do you have a car?
YES NO If NO when do you turn?	YES NO

Have you ever been convicted of a felony?
YES NO If YES please explain.
Can you work all or most Wednesdays?	Can you work all or most Sundays?
YES NO	YES NO

Availablity

	Sunday	Monday	Tuesday	Wednesday
From
To
	Thusday	Friday	Saturday
From
To

Education

High School Attended	Year Completed

College Attended	Year Completed

Other Special Training or Qualifications

Employment Experience (Start with most recent)

Name of Company (1)	Dates of Employment
	From: - To:

Name of Supervisor	Job Title

Phone #	Reason for Leaving

Name of Company (2)	Dates of Employment
	From: - To:

Name of Supervisor	Job Title

Phone #	Reason for Leaving

Name of Company (3)	Dates of Employment
	From: - To:

Name of Supervisor	Job Title

Phone #	Reason for Leaving

References (Please provide 3 non-family references)

Reference Name (1)	Phone #

Business Name (1)	Years Acquainted

Reference Name (2)	Phone #

Business Name (2)	Years Acquainted

Reference Name (3)	Phone #

Business Name (3)	Years Acquainted

BY SUBMITTING THIS APPLICATION I ATTEST THE ABOVE GIVEN INFORMATION IS TRUE AND PERSONAL FACTS HAVE NOT BEEN MISREPRESENTED NOR OMITTED.

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