Employee ApplicationPersonal InformationApplicant name* First Last Phone number*Email address* Applicant address* Street Address City State*AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you have reliable transportation?*Select an optionYesNoHave you ever been convicted of a felony?*Select an optionYesNoAre you willing to take a drug test?*Select an optionYesNoYou give your permission for Stewart Family dba Moxie Java Bistro to require a drug test prior to your hiring if you answer “yes” to this question.Date available to start* MM slash DD slash YYYY Employment HistoryWork history Company name Job titleActions EditDelete There are no Previous Jobs. Add Work History Maximum number of previous jobs reached. Education HistoryHigh school High School Name Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code High school years attended*Please enter a number from 0 to 5.Field of study in high schoolDid you earn a diploma?*Select an optionYesNoCollege/Trade school School Name Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code College/trade school years attendedPlease enter a number from 0 to 15.Field of study in college/trade schoolDid you earn a degree?Select an optionYesNoAdditional informationAvailabilityPlease fill in the location and time or shift you are available each dayMoxie Java location*Select a locationMoxie Java Twin FallsMoxie Java West FargoMoxie Java Sutton PlaceMoxie Java West AcresMoxie Java 12thMoxie Java SouthsideMoxie Java GarrityMoxie Java KunaMoxie Java Bistro Cafe LekuMoxie Java VistaMoxie Java Main StreetMoxie Java BistroAvailability*Day of the week*Starting time*Ending time* Enter the day(s) and time(s) you are available to work during a regular week. Add additional days by clicking the “+” above.Signature*By signing this form, you agree that all information provided is true and accurate to the best of your knowledge.