Koala Berry - Employment Application

Full Name (Required)
Address, City, State, Zip (Required)
Date you wish to start
Position you wish to apply for
Salary Desired (Required)
Phone
Cell Phone
Email Address (Required)
Enter Email Address Again for Verification (Required)
If hired, can you provide authorization to work in the U.S.A?
Yes No
Have you ever been convicted of a Crime?
Yes No
If yes, please explain

How many days per week would you like to work
2-3 days 3-4 days 5 or more
How many Hours per week would you like to work
8-12 hours 13-18 hours 19-29 hours 30 or more

When are you available to work?

Monday- Friday 8am-3:30 pm
Yes No
12 months per year
Yes No
Summers only
Yes No
Saturday and Sunday 8 am-3:30 pm
Yes No
12 months per year
Yes No
Summers only
Yes No
Monday-Thursday 3:30-10:30pm
Yes No
12 months per year
Yes No
Summers only
Yes No
Friday-Sunday 3:30-10:30pm
Yes No
12 months per year
Yes No
Summers only
Yes No

Employment History

Beginning with your current or most recent job, list all previous, and provide description of duties. If applicable, include military and unpaid volunteer experience, and provide explanation for dates of unemployment. Please include starting and ending dates of each job and reason for leaving.

Employer 1
Employer 2
Employer 3
Education
High School Name & Location
If in High school list all extracurricular activities you are involved with that limit your availability to work
Highest Grade Completed
9 10 11 12
Expected Graduation Date:
College Name & Location
Highest Grade Completed
1 2 3 4
Expected Graduation Date:

Please provide any additional information such as special skills; training, management experience or qualifications you feel will be helpful to us in considering your application.

Please read the following statements carefully before checking and submitting this form.

I certify that the facts contained in this application are true and complete. If employed, falsified statements, misrepresentations or omissions may result in termination. I authorize investigation of any information provided for employment related purposes. I authorize any listed employer or school to provide you with all applicable information they might have. I release all employers and schools from all liability for any information they provide about me. Koala Berry is a DRUG FREE WORK PLACE. I understand that I may be required to submit to a drug screen as part of my initial application process and ongoing employment.

Consent for Background Investigation

It is the intent of Koala Berry to keep all information we receive during our background investigation private and confidential. Please read the statement below allowing Koala Berry to verify employment and information given on this application.

I authorize a Koala Berry representative to investigate or verify any information I have given on this application, to discuss my background, past performance and my suitability for employment. I further agree to have my work background discussed by and people so contacted, and waive all my rights to bring any action for defamation, invasion of privacy, or any similar cause of action against anyone contacted as a result of what is said about me. I also understand that the information I supply may be confirmed and that any false statement or omission of facts in connection with this Application for Employment will result in no offer of employment or dismissal from Kola Berry if I am already employed.

I have read the terms of this application and wish to submit an application to Koala Berry, LLC (Required)