Step 1 of 6 16% Contact InformationPlease Note: We typically do not hire seasonal employees. If you plan to work for less than six months, your chances of being offered employment is very low without being directed to fill out the application from an HCC&T manager.Applicant Name* First Last Email Address* Best number to reach you at*Is your home and mailing address the same?*YesNoHome/Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Are you under the age of 18?*YesNoBirth Date (if under the age of 18)*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 What HCC&T location(s) are you applying for? (You may choose more than one)* Front Royal, VA Purcellville, VA The Plains, VA What HCC&T Position(s) are you applying for?*BaristaBaker/Food PrepAny Available Job OpeningWhen would you be able to start?* Date Format: MM slash DD slash YYYY What would you expect your hourly pay rate to be (Including tips?)*Employment desired*Full Time (4- 5 days/week)Part Time (3-4 days/week)Part Time (2-3 days/week)Part Time (1-2 days/week)If hired, how long do you expect to work here?*Please Note: We typically do not hire seasonal employees. If you plan to work for less than six months, your chances of being offered employment is very low without being directed to fill out the application from an HCC&T manager. 1-6 months6 months to 1 year1 year or moreIf less than 1 year, please explain*Have you applied to and/or are you waiting to hear back from any job offers that you would consider (if hired) terminating employment with Happy Creek Coffee & Tea after employment began?*NoYesIf yes, please explain:*Are you currently a high school/college student?*NoYesPlease include your current class schedule in the space below* AvailabilityAll Day = You are able to work any shift during the day. Limited Availability = You are only able to work the opening or closing shift but not both. Not Available = You are unable to work that day.What is your Sunday Availability?*All Day (Open to Close)Limited AvailabilityNot AvailablePlease explain your Sunday "Limited Availability"*Please explain why you are "Not Available" to work on Sundays*What is your Monday Availability?*All Day (Open to Close)Limited AvailabilityNot AvailablePlease explain your Monday "Limited Availability"*Please explain why you are "Not Available" to work on Mondays*What is your Tuesday Availability?*All Day (Open to Close)Limited AvailabilityNot AvailablePlease explain your Tuesday "Limited Availability"*Please explain why you are "Not Available" to work on Tuesdays*What is your Wednesday Availability?*All Day (Open to Close)Limited AvailabilityNot AvailablePlease explain your Wednesday "Limited Availability"*Please explain why you are "Not Available" to work on Wednesdays*What is your Thursday Availability?*All Day (Open to Close)Limited AvailabilityNot AvailablePlease explain your Thursday "Limited Availability"*Please explain why you are "Not Available" to work on Thursdays*What is your Friday Availability?*All Day (Open to Close)Limited AvailabilityNot AvailablePlease explain your Friday "Limited Availability"*Please explain why you are "Not Available" to work on Fridays*What is your Saturday Availability?*All Day (Open to Close)Limited AvailabilityNot AvailablePlease explain your Saturday "Limited Availability"*Please explain why you are "Not Available" to work on Saturdays* Employment HistoryAre you currently employed?*YesNoIf hired, will you end your current employment*YesNoUnsureHave you previously been employed?*YesNoIf currently/previously employed, how many employers have you had?*123+If you have never been employed, please provide any work/civic/school related clubs, etc. that you feel relevant. Also, please explain why you feel you are ready to enter the workforce and what it means to be a good employee.*Current/Previous Employer #1Please provide a list of your previous (up to three) employers. (We will not contact current employers prior to an initial interview and have the intention of moving forward with the hiring process.)Business Name of Current/Last Employer*Business Phone Number*Supervisor's Name* First Last Date Employment Started*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date Employment Ended (or will end)*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920May we contact this employer?*YesNoIf NO, please explain why:*Why did you leave (or why are you leaving) this job?*Previous Employer #2Business Name of Previous Employer #2*Business Phone Number*Supervisor's Name* First Last Date Employment Started*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date Employment Ended*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920May we contact this employer?*YesNoIf NO, please explain why:*Why did you leave this job?*Previous Employer #3Business Name of Previous Employer #3*Business Phone Number*Supervisor's Name First Last Date Employment Started*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date Employment Ended*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920May we contact this employer?*YesNoIf NO, please explain why:*Why did you leave this job?* References #1Please do not include relatives or previous employers. We will not contact references prior to an initial interview.Name (Reference #1)* First Last Phone Number*Email Address* Reference #2Please do not include relatives or previous employers. We will not contact references prior to an initial interview.Name (Reference #2)* First Last Phone Number*Email Address* Highest level of education achieved*NoneCurrent High School StudentHigh School Graduate/GEDSome CollegeTechnical or Trade SchoolAssociates DegreeBachelor's DegreeMaster's DegreePHD or EquivalentHave you ever been convicted of a crime?*YesNoIf yes, please explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.*Briefly explain why you want to work for HCC&T and why you feel you would be a good fit.*Please upload a copy of your resume if you have one Drop files here or