Poad's Pizza
Employment Application
Full Name *
Today's Date *
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Birthday *
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Mailing Address *
Cell Phone Number *
Email *
Referred By?
Are you 18 years old or older? *
Position Desired *
Required
Available Start Date *
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Desired Salary?
Weekday Afternoon Availability 10am - 3pm *
Required
Weekday Evening Availability 3pm - 9pm *
Required
Weekend Availability 2pm - 9pm *
Required
Are you currently employed? *
If you are currently employed, what is the name of your employer?
What is the name of the high school you attended? *
Did you graduate? *
Have you attended any other post-secondary schools? *
What is the name of your most recent employer? *
What is the name of your supervisor there? *
What was your position? *
What was your salary upon leaving? *
What is the reason for leaving? *
What skills and/or prior experience do you have that are related to the position you are applying for? *
Please provide the name and phone number for a person of reference. *
Please provide the name and phone number for a second person of reference. *
I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any false statement, omission or misrepresentation on his application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the Company. I understand that any employment is conditioned on a background check. I authorize the Company to thoroughly investigate all statements contained in my application and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the Company, without giving me prior notice of such disclosure. In addition, I release the Company, any former employers and references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure. I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contact. I further understand and agree that if I am hired, my employment will be “at will” and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless made in writing by an authorized Company representative. If I am offered employment I agree to submit to a medical examination and drug test, if required, before starting work. If employed, I also agree to submit for a medical examination or drug test at any time deemed appropriate by the Company and as permitted by law. I consent to such examinations and tests and I request that the examining doctor disclose to the Company the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent permitted by law, is contingent upon satisfactory medical examinations and drug tests, if required, and if I am hired a condition of my employment will be that I abide by the Company’s Drug and Alcohol Policy. I understand that acceptance of this form does not indicate there is a position open and does not obligate the Company to hire. If hired, I agree to abide by all Company work rules, policies and procedures. The Company retains the right to revise its policies or procedures, in whole or in part, at any time. *
Please provide your typed name as your electronic signature that everything on this application are true to the best of your knowledge. *
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