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Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
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California
Colorado
Connecticut
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District of Columbia
Florida
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Hawaii
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Texas
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Washington
West Virginia
Wisconsin
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Home Phone
*
Cell Phone
*
Email
Are you a citizen of the United States?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
Are you over the age of 18?
*
Yes
No
Date available to start?
*
MM slash DD slash YYYY
Desired Position (Select all that apply)
*
Pizza Cook
Cashier
Manager
Driver
Do you have reliable transportation to and from work?
*
Yes
No
Please provide your definition of “Teamwork”
*
Please provide your definition of “Integrity”
*
Please provide your definition of “Humility”
*
Please provide your definition of “Initiative”
*
Please provide your definition of “Emotional Inteligence”
*
Which shifts would you be available for?
*
Monday 9am-4pm
Monday 4pm-10pm
Tuesday 9am-4pm
Tuesday 4pm-10pm
Wednesday 9am-4pm
Wednesday 4pm-10pm
Thursday 9am-4pm
Thursday 4pm-10pm
Friday 8am-4pm
Friday 4pm-11pm
Saturday 8am-4pm
Saturday 4pm-11pm
Sunday 9am-4pm
Sunday 4pm-10pm
High School Name
*
High School Zip Code
*
High School Start Date
*
MM slash DD slash YYYY
High School End Date
*
MM slash DD slash YYYY
Did you attend another High School?
*
Yes
No
High School Name
*
High School Zip Code
*
High School Start Date
*
MM slash DD slash YYYY
High School End Date
*
MM slash DD slash YYYY
Have you graduated High School?
*
Yes
No
Have you attended college?
*
Yes
No
College Name
*
College Zip Code
*
College Start Date
*
MM slash DD slash YYYY
College End Date
*
MM slash DD slash YYYY
Reference #1 Name
*
First
Last
Relationship
*
Phone
*
Email
Reference #2 Name
*
First
Last
Relationship
*
Phone
*
Email
Reference #3 Name
*
First
Last
Relationship
*
Phone
*
Email
Employer #1 Name
*
Employer Phone
*
Supervisor Name
*
First
Last
Job Title
*
Final Pay Rate
*
Start Date
*
MM slash DD slash YYYY
End Date
*
MM slash DD slash YYYY
Reason for leaving
*
May we contact this employer for a reference?
*
Yes
No
Have you had any other employment in the last 2 years?
*
Yes
No
Employer #2 Name
*
Employer Phone
*
Supervisor Name
*
First
Last
Job Title
*
Final Pay Rate
*
Start Date
*
MM slash DD slash YYYY
End Date
*
MM slash DD slash YYYY
Reason for leaving
*
May we contact this employer for a reference?
*
Yes
No
Have you had any other employment in the last 2 years?
*
Yes
No
Employer #3 Name
*
Employer Phone
*
Supervisor Name
*
First
Last
Job Title
*
Final Pay Rate
*
Start Date
*
MM slash DD slash YYYY
End Date
*
MM slash DD slash YYYY
Reason for leaving
*
May we contact this employer for a reference?
*
Yes
No
Phone
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