Job Application 12 - Nikolas Pizza

Personal Information
Name*
First Last
Social Security Number*
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Permanent Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number*
Secondary Phone Number*
Reference By*
Employment Desire
Email*
Position*
Date you can start*
Date Format: MM slash DD slash YYYY
Salary Desired*
If yes, may we insure of your present employer?*
- Yes
- No
Ever applied to this company before?*
- Yes
- No
Are you employed now?*
- Yes
- No
Where*
When*
Education History
High School
Name & Location of school
Year Attended
Did you graduate?
Subject Studied
College
Name & Location of school
Year Attended
Do you graduate?
Subject Studied
Trade, Business or Correspondence School
Name & Location of school
Year Attended
Do you graduate?
Subject Studied
General Information
Subject or special Study/Research work
Special Training
Special Skills
US Military or Neval Services
Rank
Former Employee
From*
Date Format: MM slash DD slash YYYY
Name & Address of Employee*
Salary*
Position*
Reason For Leaving*
To*
Date Format: MM slash DD slash YYYY
Name & Address of Employee*
Salary*
Position*
Reason For Leaving*
References (give below the names of 3 persons not related to you, whom you have known at least one year)
Reference #1*
Business address*
Business name*
Years known*
Reference #2*
Business address*
Business name*
Years known*
Reference #3*
Business address*
Business name*
Years known*
Authorization*
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, it employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all in- formation concerning my previous employment and any pertinent Information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment." In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to com- plete the required employment eligibility verification document form upon hire.

Personal Information

Employment Desire

Education History

High School

College

Trade, Business or Correspondence School

General Information

Former Employee

References (give below the names of 3 persons not related to you, whom you have known at least one year)

Gift Certificates are available in store or by phone

Revised Business Hours