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Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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
Comments
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