Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

What is the most convenient way to contact you? *

E-mail

Phone

Both

What Position are you applying for? *

In-Store Position

Warehouse

Administration

If applying for the Delivery Position, do you have a valid US Driver's License?

YES

NO

What language(s) do you speak? *

Select one or more

English

Haitian-Creole

French

Spanish

Other

Education Level *

Some High School, No Diploma/In-Progress

High School or GED

Some College, No Degree/InProgress

Vocational/Technical Training/Intership

Associate Degree

Bachelor Degree

Master's Degree and Higher

Are you legally able to work in the US? *

YES

NO

Are you 18 years or older? *

YES

NO

Would you be joining us part-time or full-time? *

Full-TIme

Part-Time

Which shift(s) are you available to work?

Select one or more

Morning

Mid-Day

Evening

Are you willing to work on holidays? *

YES

NO

Are you physically able to perform a job that requires you to complete many different physical tasks, such as standing, walking, twisting and lifting objects up to 40 pounds, in a fast paced environment? This includes maintaining store cleanliness and preparing food and beverage products to customer satisfaction, with or without accommodation?

YES

NO

Do you have previous work history? (If no, please continue to the next section of the application) *

YES

NO

Your Employer's Phone Number

(###)

###

####

Date You Started Working with Employer

MM

DD

YYYY

Date You Ended Working with Employer

ONLY if you are no longer employed by them.

MM

DD

YYYY

When will you be able to start working with us?

MM

DD

YYYY

Are you available to work on weekends?

Yes

No

What days are you able to work?

Select one or more.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

If called in for an interview, what day(s) of the week can you come in?

Select one or more

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

By clicking the button below, I am fully aware that I am not guaranteed a Job at Pate Lacaye Inc. I am acknowledging that this application went to the Human Resources Department. *

CLICK HERE