Caliche Employee Application

Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date you can start *

MM

DD

YYYY

Are you looking for full-time or part-time employment? *

Full-Time

Part-Time

As Needed (a few shifts a month)

Days Available *

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Areas of Interest *

Check all that apply

Vinyl

Vintage Clothing & Accessories

Books

Art

Live Performances

Vendor Markets

Community Meetings

Date Employed *

MM

DD

YYYY

Date Left

If applicable

MM

DD

YYYY

Date Employed *

MM

DD

YYYY

Date Left *

MM

DD

YYYY

Date Employed *

MM

DD

YYYY

Date Left *

MM

DD

YYYY

Reference #1 *

First Name

Last Name

Phone *

(###)

###

####

Reference #2 *

First Name

Last Name

Phone *

(###)

###

####

I certify that answers given herein are true, correct and complete to the best of my knowledge. I authorize investigation of all statements contained in this application as may be necessary in arriving at an employment decision. I understand that false or misleading information may be cause for disqualification from or subsequent termination of employment. I understand and agree that, if hired, my employment is at will, for no definite period and may be terminated at any time with or without cause or prior notice, unless provided otherwise by law. *

I agree

Signature *

First Name

Last Name

Today's Date *

MM

DD

YYYY