Please fill out the following application completely. Then press the button below to email your application to Java Jockey Vending Service.
Java Jockey Vending Service
4844 Whirlwind * San Antonio, Texas 78217 * (210)656-8804

We are an equal opportunity employment company. We are dedicated to a policy of non-discrimination in employment on any basis including race, creed, color, age, sex, religion or national origin.

Date:    Email Address:
Driver's License ##:    State:    SS##:   

Application for Employment
Personal Information
Last Name:    First Name:    Middle Initial:   
Present Address - Street:    City:    State:   
Permanent Address - Street:    City:    State:   
Phone Number:    Referred By:   
Employment Desire
Position:    Date you can start:    Salary Desired:   
Are you employed now?    If so, may we inquire of your present employer?   
Ever applied here before?    If "yes", when?   
Education
 Name and Location of SchoolYears
Attended		Date
Graduated		Subjects
Studied
Grammer School
High School
College
Trade, Business or Correspondence School

Special Studies:   
U.S. Military:    Rank:    Are you in National Guard or Reserves?   
Activities other than religious:   
(Civic, athletic, fraternal, etc. - Exclude organizations the name of which indicates race, creed, color, or national origin.)
Former Employers
List last four employers, starting with most recent.
Date
(Month/Year)		Name and Address of EmployerWagePositionReason for Leaving
From:     
To:      
From:     
To:      
From:     
To:      
From:     
To:      
References
Below, give the names of two persons not related to you whom you have known at least one year.
NameAddressBusinessYears
Acquainted


Physical Record
List any physical defects:
Were you ever injured?    If so, give details:
Have you defects in hearing?    In vision?    In Speech?   
In case of emergency, notify:
   Name:   Address:
   Phone:

I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts is cause for dismissal. Further, I understand and agree my employment is for no definite period and may, regardless of the date of payment of my wages or salary, be terminated at any time without previous notice.

Date:    Signature:
To be Completed Day Employment Begins                                                         Date:   

Height:    Weight:    Age:    Date of Birth:   
Single:    Married:    Widowed:    U.S. Citizen:    Sex:   
(The above information is for pension, hospitalization, insurance, etc., not for hiring purposes.)

Interviewed by:    Date:    Remarks:   
Neatness:    Character:   
Personality:    Ability:   
Hired:    Position:    Report on:    Salary/Wage   
Approved by: