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Kenosha Pizza

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Step 1 of 5 - Application Information

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Name*
First Last
Address*
Street Address Address Line 2 City 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?*
Date Format: 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*
Date Format: MM slash DD slash YYYY
High School End Date*
Date Format: MM slash DD slash YYYY
Did you attend another High School?*
- Yes
- No
High School Name*
High School Zip Code*
High School Start Date*
Date Format: MM slash DD slash YYYY
High School End Date*
Date Format: 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*
Date Format: MM slash DD slash YYYY
College End Date*
Date Format: 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*
Date Format: MM slash DD slash YYYY
End Date*
Date Format: 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*
Date Format: MM slash DD slash YYYY
End Date*
Date Format: 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*
Date Format: MM slash DD slash YYYY
End Date*
Date Format: MM slash DD slash YYYY
Reason for leaving*
May we contact this employer for a reference?*
- Yes
- No
Email
This field is for validation purposes and should be left unchanged.

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