## Job Application Position that you are applying for?**\*** Position that you are applying for? Cashier Cook Driver Busser Management Invalid Input How were you referred to us?**\*** How were you referred to us? Website Friend Pie Employee Word of Mouth Other Invalid Input Which Location(s) are you applying to?**\*** Which Location(s) are you applying to? Underground Salt Lake Delivery Midvale Ogden South Jordan South Salt Lake Invalid Input First Name**\***Invalid Input Last Name**\***Invalid Input Street Address**\***Invalid Input City**\***Invalid Input State**\***Invalid Input Zip Code**\***Invalid Input Cell Phone (or best phone #)**\***Invalid Input Home PhoneInvalid Input Work PhoneInvalid Input Email Address**\***Invalid Input Are you over the age of 16?**\*** Are you over the age of 16? Yes No Invalid Input Are you over the age of 18?**\*** Are you over the age of 18? Yes No Invalid Input Are you over the age of 21?**\*** Are you over the age of 21? Yes No Invalid Input Do you have a reliable source of transportation?**\*** Do you have a reliable source of transportation? Yes No Invalid Input **EMERGENCY CONTACT** Emergency Contact**\***Invalid Input Relationship to you**\***Invalid Input Emergency Contact Number**\***Invalid Input **EMPLOYMENT INFO** Are you currently employed?**\*** Are you currently employed? Yes No Invalid Input May we contact them?**\*** May we contact them? Yes No Invalid Input Supervisor Name and Number?**\***Invalid Input Do you have any previous Pizza or Restaurant experience? Do you have any previous Pizza or Restaurant experience? Yes No Invalid Input Have you ever worked for The Pie Pizzeria? Have you ever worked for The Pie Pizzeria? Yes No Invalid Input When did work for the Pie?Invalid Input Do you know anyone who currently works for The Pie Pizzeria? Do you know anyone who currently works for The Pie Pizzeria? Yes No Invalid Input Who do know that works for the Pie?Invalid Input Wage DesiredInvalid Input When can you start?Invalid Input Your availability**\*** Your availability Monday Tuesday Wednesday Thursday Friday Saturday Sunday Mornings Afternoons Evenings Weekends Holidays Invalid Input Number of hours you wish to work per week?Invalid Input **WORK EXPERIENCE** Current or most recent employerInvalid Input Current or most recent positionInvalid Input Dates employedInvalid Input May we contact them? May we contact them? Yes No Invalid Input Contact NameInvalid Input Contact Phone NumberInvalid Input Previous EmployerInvalid Input Previous PositionInvalid Input Dates employedInvalid Input May we contact them? May we contact them? Yes No Invalid Input Contact NameInvalid Input Contact Phone NumberInvalid Input **REFERENCES** Please list three people who are able to complete a reference referral on your behalf. Your application cannot be processed until these referrals are returned to us. Reference 1**\***Invalid Input Reference 1 Phone**\***Invalid Input Reference 2**\***Invalid Input Reference 2 Phone**\***Invalid Input **EDUCATION** Indicate levels of education completed**\*** Indicate levels of education completed High School Some College Bachelor Degree Graduate Degree Invalid Input School and Field(s) of StudyInvalid Input --- DRIVING HISTORY (ONLY complete when applying for a position which requires you to drive your personal vehicle.) Do you have a clean driving record? (No more than 2 moving violations and no major violations.)**\*** Do you have a clean driving record? (No more than 2 moving violations and no major violations.) Yes No Invalid Input Do you own a reliable automobile with current registration? Do you own a reliable automobile with current registration? Yes No Invalid Input Do you have proof of auto insurance with your name listed on the policy? Do you have proof of auto insurance with your name listed on the policy? Yes No Invalid Input Do you have 2 or more years operating an automobile? Do you have 2 or more years operating an automobile? Yes No Invalid Input Which state are you a residence of? How long?Invalid Input Auto Insurance CompanyInvalid Input Policy NumberInvalid Input Is your driver’s license subject to any restrictions that would impair your ability to drive for our Company? Is your driver’s license subject to any restrictions that would impair your ability to drive for our Company? Yes No Invalid Input Please explainInvalid Input Have you been involved in any auto accidents in the past 3 years? Have you been involved in any auto accidents in the past 3 years? Yes No Invalid Input List accident(s) and datesInvalid Input **CAR USAGE DETAILS** All employees involved in product delivery for the Company using their personal vehicles must have their driving records reviewed before beginning employment and periodically thereafter, and all employees must also meet the following requirements: • No individual will be allowed to drive any vehicle for our Company without a valid driver’s license from the state of their primary residence. License must be in good standing (i.e., not suspended, revoked or restricted). • Individuals 18 years of age must have at least a two-year driving history. Individuals 19 years of age and over must have at least a one-year driving history. This must be the year immediately preceding the date of the evaluation. At least three years of driving history may be evaluated for all applicants and employees. • Individuals must show proof of and maintain auto liability insurance. • Individuals must have their personal vehicle pass a vehicle safety inspection at the time of hire and periodically thereafter. • No individual may be hired into a position which requires driving unless their driving record meets the Company’s standards. --- I understand that the Company is committed to providing equal opportunity in all employment practices, including, but not limited to, selection, hiring, promotion, transfer, and compensation to all qualified applicants and employees without regard to age, race, color, national origin, sex, religion, disability, citizenship status, or any other category protected by federal, state, or local law. I authorize the Company to inquire with any current or former employers, professional, work, educational and personal references listed in the application, or any other individuals I may name concerning my work experience. I understand that the Company reserves the right, to the extent permitted by law, to require drug and alcohol screening tests of an applicant or an employee either prior to beginning employment or anytime during employment. I understand that this employment application and any other Company documents provided during the application process are not promises of employment. Subject to any requirements or restrictions by state or local law, I understand and agree that, if hired, my employment is for no definite period of time and either I or the Company can terminate employment at any time, with or without cause, and with or without notice. This at-will employment relationship exists regardless of any other statements and/or policies to the contrary. My signature below indicates that I understand and agree that this at-will relationship may not be modified or amended unless in writing by a document that is signed by an authorized representative of the Company. Any other attempted form of modification is null and void, whether oral, written, expressed or implied. I certify that the information given by me on this application and during the interview process is true and complete in all respects, and I agree that if the information is found to be false, misleading, or unsatisfactory in any respect (in the Company’s judgment) that I will be disqualified from consideration for employment or subject to immediate dismissal if discovered after I am hired. I understand that I can contact the Company to determine the time period that this application will be considered active. If I wish to be considered for employment after any time period that this application is considered active, I understand that I must reapply. I further understand that separate applications may be required for each position for which I wish to be considered. Signature**\***Invalid Input