Employee Contact Details

Which Store Do You Primarily Work In? *

Select the name of the store you work at primarily

CPH Cupertino
CPH Dublin
CPH Fremont Mission
CPH Milpitas
CPH Palo Alto
CPH Pleasanton
CPH San Jose Evergreen
CPH Sunnyvale
SAZZ Corporate
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First Name *

Last Name *

Phone *

Email *

Address *

City *

State *

Postal code *

Organization

Date of birth *