Careers Employment Application Step 1 of 4 25% Hello! Thanks for considering applying to Juice Stop. We are always on the lookout for self-motivated, fun, out-going employees who can put a smile on someone’s face. After you fill out the form, we’ll contact you if you are a fit to let you know if there is an opening. Please make sure to fill out the form completely.Personal InformationName* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email* Are you at least 16 years of age?*Yes, I am 16 or olderNo, I am not yet 16 AvailabilityAre you legally able to be employed in the United States?*YesNoWhich location(s) are you interested in working at?* Eagle Run, 129th and Maple Lakeside Plaza, 171st & Center Aksarben Village, 67th & Center Downtown, 12th & Howard Gretna Fremont, NE Columbus, NE What is your availability?Sunday*Monday*Tuesday*Wednesday*Thursday*Friday*Saturday*How many hours would you like to work per week?*When are you available to start?* Date Format: MM slash DD slash YYYY School Most Recently AttendedName of School*Last grade completed?*Now Enrolled?*YesNoGraduated?YesNoSports or Activities? Most Recent Employment (if any)CompanyAddress Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code PositionStart Work DateEnd Work DateReason for leavingDo we have permission to contact the employer?YesNoIf no, why?*CommentsThis field is for validation purposes and should be left unchanged.