Glass Nickel Pizza

Personal Information:

Location:

Name:

Address:

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Phone Number:

Email:

Are you 18 years of age or older?

Yes

Former Employers:

Most Recent/Present:

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Position:

Wage:

Reason for leaving:

Previous Employer 2:

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Personal References:

Reference 1:

Name:

How do you know them,
and for how long:

Phone:

Reference 2:

Name:

How do you know them,
and for how long:

Phone:

Reference 3:

Name:

How do you know them,
and for how long:

Phone:

Employment Desired:

Position Desired:

Date Available:

Hours Available:

Salary Desired:

Are you currently employed?

Yes

Present work hours?

Are you in school?

Yes

What are your hours?

Have you previously applied here?

Yes

If so, when?

Were you referred by a current employee?
If so, who?

The company is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, age, sex, color, religion, national origin, citizenship or disability.

I, authorize investigation of all statements in this application. I understand that misrepresentation or omission of facts called for is reason for dismissal. Further, I understand and agree that my employment is for no definite time period and may, regardless of the date of payment of my wages and/or salary be terminated at any time without any prior notice.

Your initials:

Full Service Dine-In and Bar (Eastside Location Only) Award Winning Pizza ~ Extensive Menu Parties ~ Family Gatherings ~ Office Meetings Advance Ordering ~ Business Accounts available