Coa Chocolate Employment Application 

*formerly Pick Me Up Chocolate

Question Title

* 1. Contact information

Question Title

* 2. What is your Instagram handle?

Question Title

* 3. What is your expected pay per hour?

Question Title

* 4. Do you have transportation to work?

Question Title

* 5. Are you legally authorized to work in the United States?

Question Title

* 6. Are you 18 or over?

Question Title

* 7. If no, are you 16 or over?

Question Title

* 8. Please enter your the name of your school and graduating year

Question Title

* 9. Please enter your most recent employers and positions held. 

Question Title

* 10. Total hours available per week

Question Title

* 12. What is your desired start date?

Date
1. I certify that I have read this application and the information on it is complete and correct.  

2. I authorize the persons, employers, schools and organizations listed on this application to give you any information concerning my employment and other pertinent information they may have, personal and otherwise, and release all parties from all liability and damages that may result from furnishing this to you. 

3.  Coa Chocolate is an equal opportunity employer.  Various federal, state and local laws prohibit discrimination on account of race, color, religion, sex, age, national origin, disability, veteran's status or other protected categories.  It is Coa Chocolate's policy to comply fully with these laws, as applicable, and the information requested on this application will not be used for any purpose prohibited by law.

Question Title

* 13. Please enter your name to electronically certify your application. 

T