Employment Application — Lee's Coffee & Tea

1Applicant information

Full name * Preferred name

Phone * Email *

Address (street, city, state, ZIP)

At least 18 years old? *

Yes No

Under 18? You're welcome to apply — youth-employment rules apply at hire.

Authorized to work in the U.S.? *

Yes No

Have you worked at Lee's before?

Yes No

2Position & availability

Position of interest — pick all that apply *

Employment type * Date available to start Hours / week desired

Weekly availability — store hours are Mon–Fri 7a–6p, Sat 7a–5p, Sun 8a–4p. Leave a day's times blank or check "N/A" if you can't work it.

Day	N/A	Earliest start	Latest end

Regular commitments we should plan around (school, second job, sports, etc.)

3Experience

Most recent employer

Employer Your role Dates (from – to)

Reason for leaving May we contact them?

Previous employer (if any)

Employer Your role Dates (from – to)

Reason for leaving May we contact them?

Food-safety or other certifications, if any (none required to apply)

In a few lines: why Lee's, and what would you bring to the counter? *

4References

Two people who know your work — former managers, coworkers, coaches, or teachers.

Name Relationship Phone

5Certification

I certify that the information on this application is true and complete to the best of my knowledge, and I understand that false or misleading statements may disqualify me from consideration or, if discovered after hire, may result in dismissal. I authorize Lee's Coffee & Tea, LLC to contact the employers and references listed above. I understand that employment at Lee's Coffee & Tea is at-will, that this application is not a contract of employment or a guarantee of hire, and that it will be kept on file for 90 days.

I have read and agree to the statement above. *

Type your full name as your signature * Date *

Please complete the required fields marked with * — including at least one position.

Your application goes straight to lct@leescoffeetea.com and is kept on file for 90 days. Prefer paper? Pick one up at the counter at 409 W Oak St.

Lee’s Coffee & Tea