Name *

First Name

Last Name

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Mobile Phone Number. We often text our applicants to arrange a time to meet and discuss openings.

(###)

###

####

Which location(s) are you available to work? *

Check all that apply

Bellevue

Shaler

Wexford (Within AHN Health and Wellness Pavilion)

NorthSide (Inside AGH Hospital)

Monroeville (Inside Forbes Hospital)

Birthdate

Optional for now, but we will need it if you are hired

MM

DD

YYYY

Are you 18 years of age or older? *

Yes

Not Yet

Have you ever been convicted of a crime? *

Do not answer "Yes" if the violation was non-DUI related traffic citations. NOTE: All applicants go through a criminal background check prior to being offered a position of employment

Yes (Explain Below)

No

Days you are available to work

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Roughly how many hours are you wanting to work? *

5-10

10-20

20-30

30-40

What day could you start? *

MM

DD

YYYY

Education *

In High School

High School Diploma or GED

Trade Technical School

Completed Some College Coursework

Graduated College

Do you agree with the following terms? *

In exchange for the consideration of my job application by BeanThru LLC (hereinafter called “the Company”), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of BeanThru LLC, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the Owner / General Manager of the Company. Both the undersigned and BeanThru LLC may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract. I also understand the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act. I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

Yes

No