ECOM

Timothy Nguyen's Employment Application

Date Submitted: 4/6/2017

Job Title: General Labor

Job Location: Houston

Personal Information

First Name: Timothy

Last Name: Nguyen

Email: adzmdj@r.postjobfree.com

Current Address

Address: 10623 Wingtip, 7904 Swiftwater

City: Houston

State: TX

Postal Code: 77075

Country: US

Contact Information

Home Phone: 713-***-****, 713-***-****

Cell Phone: 281-***-****, 281-***-****

General Information

How did you hear about us? Internet

Have you ever been employed here before? No

If yes, give dates and position: n/a

Are you legally eligible for employment in this country? Yes Employment desired: Full-Time

Available Start Date: 04/09/2017

Have you ever been convicted of a felony or subjected to deferred adjudication on a felony charge? No If yes, explain in concise detail, giving dates and nature of the offense, name and location of the court, and disposition of the case(s). A conviction may not disqualify you, but a false statement will.: n/a Education/Training

High School

Name of School: Milby High School

Location: Houston

Grade Completed: 11

Graduate or GED? No

College or University

Name of School: HCC

Location: Houston

Course or Major: 0

Years Completed: n/a

Degree: n/a

Graduate? No

Business or Trade School

Name of School: n/a

Location: HouSton

Course or Major: n/a

Years Completed: n/a

Degree: n/a

Graduate? No

Professional School

Name of School: n/a

Location: Houston

Course or Major: n/a

Years Completed: 1

Degree: n/a

Graduate? No

References

Please list two business/work references that are not related to you and not a previous supervisor. If not applicable, list two personal references that are not related to you:

1st Reference

Name: Schwan

Position: Operaton

Company: Schwan

Address: 1251 Scarborough

Phone: 713-***-****

2nd Reference

Name: McDonald

Position: Cook

Company: McDonald

Address: 8420 Clearwood

Phone: 713-***-****

Military Service

Have you ever been in the Armed Forces? No

Are you now a member of the National Guard? No

Specialty: n/a

Date Entered: n/a

Discharge Date: n/a

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.

Current or Most Recent Employer

Company Name: n/a

Location: n/a

Last Job Title: n/a

Last Supervisor: n/a

From (MM/YY): n/a

To (MM/YY): n/a

Starting Pay: n/a

Ending Pay: n/a

Reason for Leaving (be specific): n/a

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company: n/a

2nd Previous Employer

Company Name: n/a

Location: n/a

Last Job Title: n/a

Last Supervisor: n/a

From (MM/YY): n/a

To (MM/YY): n/a

Starting Pay: n/a

Ending Pay: n/a

Reason for Leaving (be specific): n/a

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company: n/a

3rd Previous Employer

Company Name: n/a

Location: n/a

Last Job Title: n/a

Last Supervisor: n/a

From (MM/YY): n/a

To (MM/YY): n/a

Starting Pay: n/a

Ending Pay: n/a

Reason for Leaving (be specific): n/a

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company: n/a

4th Previous Employer

Company Name: n/a

Location: n/a

Last Job Title: n/a

Last Supervisor: n/a

From (MM/YY): n/a

To (MM/YY): n/a

Starting Pay: n/a

Ending Pay: n/a

Reason for Leaving (be specific): n/a

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company: n/a

5th Previous Employer

Company Name: n/a

Location: n/a

Last Job Title: n/a

Last Supervisor: n/a

From (MM/YY): n/a

To (MM/YY): n/a

Starting Pay: n/a

Ending Pay: n/a

Reason for Leaving (be specific): n/a

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company: n/a

Final Questions

May we contact your present employer? Yes

Did you complete this application yourself? Yes

If not, who did? n/a

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying: n/a

Applicant's Statement

In exchange for the consideration of my job application by Atlantic Coffee Solutions (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 Atlantic Coffee Solutions 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 President /General Manager of the Company, except for those employees governed by a collective bargaining agreement where the terms therein and relevant labor law shall apply. Both the undersigned and Atlantic Coffee Solutions 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 except for those employees governed by a collective bargaining agreement.

I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for may result in the Applicant not being hired and is also 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 that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that any offer of employment is conditioned upon my passing a job-related medical and physical exam that establishes my ability to perform the essential functions of my job, including those circumstances when reasonable accommodations may be required. Post-employment drug testing for employees governed by the collective bargaining agreement will be conducted pursuant to the terms therein. I understand that, in connection with the routine processing of your employment application, 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 understand that as a condition of employment, I will be required to provide legal proof of authorization to work in the United States.

I have read and agree to this disclaimer.: Yes

Applicant Signature: TimothyNguyen

Date: 04/06/17

EEO Notice

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.

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