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Russo’s Employment Application Form

APPLICANT INFORMATION

Name*
M.I.
Apply Date:
 / 
 / 
Address*
Phone:*
-
E-mail*
Date Available*
 / 
 / 
Desired Salary*
Position Applied for*
Location*
Are you a citizen of the United States?*
If no, are you authorized to work in the U.S.?*
Have you ever worked for this company?*
If so, when?
Have you ever been convicted of a felony?*
If yes, explain

EDUCATION

High School*
High School Address*
High School Duration*
Did you graduate high school?*
High School Degree*
College
College Address
College Duration:
Did you graduate college?
College Degree
Other
Address*
Duration
Did you graduate?
Degree

REFERENCES

Please list three professional references.

Provide Full Name, Relationship, Company, Phone and Address*

All Qualified Applicants will receive consideration without regard to race, color, sex, religion, age, national origin, handicap or veteran status.

PREVIOUS EMPLOYMENT

1.1 Company*
1.2 Phone*
-
1.3 Address
1.4 Supervisor*
1.5 Job Title*
1.6 Starting Salary
1.7 Ending Salary
1.8 Responsibilities*
1.9 Duration*
1.10 Reason for Leaving*
1.11 May we contact your previous supervisor for a reference?
2.1 Company
2.2 Phone:
-
2.3 Address
2.4 Supervisor
2.5 Job Title
2.6 Starting Salary
2.7 Ending Salary
2.8 Responsibilities
2.9 Duration
2.10 Reason for Leaving
2.11 May we contact your previous supervisor for a reference?*

MILITARY SERVICE

Branch
Branch Duration
Rank at Discharge
Type of Discharge
If other than honorable, explain

AVAILABILITY

When are you available to work? Fill in Hours Available.

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

OTHER ACCOMPLISHMENTS

Please list below any other job related accomplishments, professional distinctions, certifications, or verifiable volunteer work.

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge, and I authorize investigation of all statements contained in this application, with exception of contacting my present employer if I have so requested on page two. I have read, understand and agree to the above statement.

I understand that my continued employment will depend upon the successful completion of work assigned to me during a new hire period of up to ninety (90) days and upon my continued successful performance. I have read, understand and agree to the above statement.

While this application will be retained on file for a period of one year (as required by law), I acknowledge that this application will be considered active for a period of sixty (60) days. At that time, I must submit a new application to be considered for any employment openings. I have read, understand and agree to the above statement.

If I should be employed by the Company, I understand that any false, incomplete, or misleading information given on this application or during an interview shall result in immediate discharge.

I have read, understand and agree to the above statement. I authorize an inquiry into my background by all persons, schools, companies, corporations, credit bureaus, law enforcement agencies, doctors and other consumer reporting agencies to supply information concerning my previous employment, education, credit, driving record, etc. I have read, understand and agree to the above statement.

I authorize the references listed above to give representatives of the New York Pizzeria, Inc. any and all information concerning my previous or current employment and any pertinent information they may have, personal or otherwise, and release all parties form any and all liability from any damage that may result. I have read, understand and agree to the above statement.

Approve*

New York Pizzeria, Inc. is an Equal Opportunity Employer. New York Pizzeria, Inc. does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employments on a bases prohibited by local, state or federal law.