ON-LINE EMPLOYMENT APPLICATION
All qualified applicants receive equal consideration.  No question is asked for the purpose of excluding any applicant due to race, creed,
color, national origin, religion, age, sex, handicap, veteran status, marital status, sexual orientation, or any other legally protected status.
We are an equal opportunity employer
All fields with ORANGE text are required
NAME:
 E-MAIL ADDRESS:
STREET ADDRESS:
 PHONE NUMBER 1:
CITY:
 PHONE NUMBER 2:
STATE:
 ZIP CODE:
 SALARY DESIRED:
 per
POSITION APPLIED FOR:
Barista
 Cashier
 Retail Management
 Roadshow Sales
 Kitchen
 Sales
 Warehouse
Administrative
 Delivery Driver
 Other
DESIRED LOCATION:
Mayorga Coffee Factory
(Silver Spring, MD)
 King Farm
(Rockville, MD)
 BWI Airport
(Baltimore, MD)
 Sibley Hospital
(Washington, DC)
 Shady Grove Hospital
(Rockville, MD)
Corporate Office/Warehouse
(Rockville, MD)
Why are you interested in working with Mayorga?
Are you lawfuly elligible to work in the United States?
 Yes
 No
If you are under 18, please list your age:
Full Time
 Part Time
 Full or Part Time
Employment Desired:
How many hours can you work per week?
Can you work nights?
 Yes
 No
Days/hours Available to work:
Wednesday
Thursday
Tuesday
 Friday
Monday
from
from
 from
from
from
 to
 to
 to
 to
 to
Saturday
Sunday
from
 to
 from
 to
If hired, what date would you be available?
EDUCATION:
School Name and Location:
Undergraduate
College/University
 Graduate/
Professional
Elementary School
 High School
Years Completed:
 Years Completed:
1
 2
 3
 4
 1
 2
 3
 4
Describe any specialized training, apprenticeships, skills, and extra-curricular activities:
No
 Yes
Have you ever been convicted of a crime?
If "Yes", please explain the number of conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed,  and type(s) of rehabilitation
Are you aware of any reason why you would not be able to perform the duties of the job for which you are applying?
No
 Yes
If "Yes", please explain
EMPLOYMENT EXPERIENCE:
Please list chronologically, beginning with most recent experience
DATES EMPLOYED:
 From:
 To:
EMPLOYER NAME:
JOB TITLE:
STREET ADDRESS:
DUTIES:
PHONE NUMBER
CITY:
STATE:
 ZIP CODE:
Starting
 Final
PAY RATE:
REASON (S)FOR LEAVING:
DATES EMPLOYED:
 From:
 To:
EMPLOYER NAME:
JOB TITLE:
STREET ADDRESS:
DUTIES:
PHONE NUMBER
CITY:
STATE:
 ZIP CODE:
Starting
 Final
PAY RATE:
REASON (S)FOR LEAVING:
DATES EMPLOYED:
 From:
 To:
EMPLOYER NAME:
JOB TITLE:
STREET ADDRESS:
DUTIES:
PHONE NUMBER