Employment Application

Please fill out the following information to apply for employment with Pizza Man.

Personal Information

First Name*
Middle Name
Last Name*
Address*
City*
State*
Zip*
Phone
Are you 18 years of age or over?* Yes    No

Emergency Contact

Name
Address
Phone

Education

School Level Name and Location of School Course of Study Last grade completed Did you graduate?
High School 1    2    3    4    Yes    No
College/University 1    2    3    4    Yes    No
Post Graduate 1    2    3    4    Yes    No
Business/Technical 1    2    3    4    Yes    No

Employment Information

Position Desired*
Location*
Date you can start*
Are you currently employed?* Yes    No
What shift would you like?* 11am-6pm or 5pm-11pm
Number of hours you wish to work per week.*
Days you are available to work* Mon    Tues    Wed    Thurs    Fri    Sat    Sun
Do you have any previous pizza or restaurant experience?* Yes    No
If yes, Where? When?
Have you ever worked for Pizza Man? Yes    No
If yes, Where? When?
Name of last supervisor at Pizza Man
Reason for leaving

Employment Record Last 2 employers, most recent first

Employer 1 Name
Phone
Address
City
State
Zip
Job Title(s)
Duties
Employed From
Starting & Ending Pay (weekly)
Reason for leaving
Supervisor Name
May we contact this employer? Yes    No
Employer 2 Name
Phone
Address
City
State
Zip
Job Title(s)
Duties
Employed From
Starting & Ending Pay (weekly)
Reason for leaving
Supervisor Name
May we contact this employer? Yes    No

References

Name and phone number of three persons not related to you with whom you hae been acquainted for at least one year.
1. Name*     Phone* 
2. Name*     Phone* 
3. Name*     Phone* 

Skills

Describe any special skills or abilities

Miscellaneous

Include any additional information you feel may be helpful to us in considering your application.

Resume

Upload your resume:

Acknoweldgement

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, false statements on the application shall be grounds for dismissal.
I authorize investigation of all statements contained herein. I further authorize all listed references to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from liability for any damage that may result from furnishing same to you.
I understand and agree that, if hired my employment is for no definite period and may be terminated at any time for any reason without prior notice.

I have read and understood the above agreement.

Electronic Signature*
Date*