8/8/2019 starbucks_form

1/2

First Name: Last Name:

National Insurance Number:

Contact address:

Telephone number: (Home) (Mobile)

Permanent address and telephone number

(Email)

For Health & Safety reasons, please indicate which age bracket you fall into: Under 16 16-17 18+

* You must attach a copy of at least one of the following to this form and bring the original documentation to the interv iew as evidence of yourentitlement to work in this country. Failure to do so will invalidate your application. Please tick the relevant box.

British passport or UK or Irish birth certificate Certificate of registration/naturalisation as an British Citizen

Passport showing right to live in the UK EEC passport or identity card

Non-European passport with relevant work visa Any other document that supports your eligibility to work in the UK

J

J

J

J

J

J

Position applied for:Application FormPlease ensure that all parts of the application are completed in BLOCK CAPITALS.

Personal Information

State the hours you are available to work: 816 hours 1620 hours 2035 hours

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

From(time)

To(time)

State youravailability to work

What qualities do you have that make you suitable for this position?

Why do you think great customer service is so important to us at Starbucks?

If you have previously worked for us, please tell us when and where:

If you were introduced to us by another Starbucks Partner, please give their name, position and store:

Health InformationPlease give details and dates of any serious injuries or recurring illnesses from which you suffer/have suffered:

Please give us details of any condition/disability that could affect your ability to do this job. What reasonable adjustments could we make to enable you to work with us?

History of ConvictionsHave you ever been convicted of a criminal offence which is not a spent conviction within the terms of the Rehabilitation of Offenders Act 1974? If yes, please give full details.

Any failure to declare may result in dismissal.

Thank you for applying to join our team. Due to the significant levels of applications we receive, we are sorry that we are unable to personally respond to all cases. Successful applicants will

be contacted within 14 days.

SKU344523

90936 SB Application Form A 31/7/09 09:09 Page 1

8/8/2019 starbucks_form

2/2

Please ensure that all parts of the application are completed in BLOCK CAPITALS.

Education and Training: List below your last three places of education/training, starting with the current or most recent.

Employment History: List below your last three employers, starting with the current or most recent.

References: Please give below the names of two referees (not related to you), who can be contacted to provide a reference. If this is your first job,please supply a tutor/lecturers name.

Name & address of school or college Qualifications acheived or being studied

Length of service: Name & address of employerand type of business:

Rate of pay: Position:

Average number of hours workedeach week:

Reason for leaving:

What were your duties?

Managers name: Telephone number: May we contact them? Yes / NoPLEASE CIRCLE

Length of service: Name & address of employer

and type of business:

Rate of pay: Position:

Average number of hours workedeach week:

Reason for leaving:

What were your duties?

Managers name: Telephone number: May we contact them? Yes / NoPLEASE CIRCLE

Length of service: Name & address of employerand type of business:

Rate of pay: Position:

Average number of hours workedeach week:

Reason for leaving:

What were your duties?

Managers name: Telephone number: May we contact them? Yes / NoPLEASE CIRCLE

My signature confirms that all the information given of this application form is true and complete. I understand that any falsification of deliberateomission may disqualify my application of lead to my dismissal. I confirm that I am entitled to work in the UK. I understand that my employment issubject to references that are satisfactory to Starbucks

Signed: Date:

2006 Starbucks Coffee Company UK September 2006

Name: Address and telephone number: How do you know this person?

Gaps in empoyment: Were there any gaps in employment between any of the above? If so, for how long and for what reason?

Length of gap: Between which employers: Reason:

90936 SB Application Form A 31/7/09 09:09 Page 2