Date:  ________________     Location:  ______________________    

Employment Applicat ion

Applicant Name: _______________________________________________________________

Address: _____________________________________________________________________

City/State/Zip: _________________________________________________________________

Phone: (Home)_________________________ (Cell) _________________________

Social Security #: ______________________________________________

Postion Applied For: _________________________ Desired Wage:_____________________________

Are you over 18?: ____________ Do you have reliable transportation?: ____________

How did you here about us?: _______________________________________________________

Have you ever applied with us?(if so, when): ____________________________________________

Are you legally eligible to work in the United States?: _________ Date Available?: ____________________

Are you willing to work nights and weekends?: ________ Exceptions?:_______________________________

Are you able to perform essential functions of the job?:_____ Exceptions?: ____________________________

List of Relevant Skills: ___________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Education: High School:________________________ Years attended:______________ Degree Y/N:______

College: ___________________________ Years: _________ Degree Y/N(area of study): ________________

 

Employment History

Employer: _______________________________ Supervisor: ____________________________________

Address:_________________________________________________ Phone: _______________________

Dates Employed:____________________________________________ Ending Wage: _______________

Job Responsibilities:_______________________________ Reason for Leaving:______________________

Employer: _______________________________ Supervisor: ____________________________________

Address:_________________________________________________ Phone: _______________________

Dates Employed:____________________________________________ Ending Wage: _______________

Job Responsibilities:_______________________________ Reason for Leaving:______________________

Employer: _______________________________ Supervisor: ____________________________________

Address:_________________________________________________ Phone: _______________________

Dates Employed:____________________________________________ Ending Wage: _______________

Job Responsibilities:_______________________________ Reason for Leaving:______________________

References(non related)

Name:_________________________ Name: __________________________

Number: ______________________ Number:_________________________

Relationship:____________________ Relationship:______________________

I authorize Gusto Pizza Co. to contact former employers, educators and references regarding my employment and education. I authorize my former employers, educators and references to fully and freely communicate regarding my previous employment, attendance, and grades.

I certify the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

Print Name:________________________________ Signature(date): _______________________________