Employment

Name*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Which location are you appling for?*

Do you have transportation to and from work?*

Yes
No

Drive License Number:

Positions applying for*

Date available*

Salary desired*

Are you interested in (select all that apply)

Full-Time
Part-Time
Temporary
Summer

Age, if under 21

DOB if under 21

If you were referred to Westgate Pizza, by whom

Do you have, or have you had in the last six months, hepatitis, salmonella, gastrointestinal infections or any other disease, which might be spread through food service or preparation?*

Yes
No

Please explain:

Education

List your educational background:*

Name/Location of School	Degree/Area of Study	Graduated/Date	Number of Years Attended

EMPLOYMENT EXPERIENCE

(List most recent experience first)

Are you currently employed?*

Yes
No

May we contact your current employer?*

Yes
No

Please list the best telephone number to reach your current employer:

List your employment background:*

Name and Address of Employer/Dates of Employment	Position(s) Held/Supervisor	List Duties	Reason for Leaving

UNITED STATES MILITARY SERVICE

Please list your military exepience

Branch of Service	Technical Specialization	Rank Attained

REFERENCES

Please list your references:*

Name and Address	Telephone Number	Relationship/Years Known

LEGAL

Are you a U.S. citizen?*

Yes
No

If no, do you have a legal right and necessary documents to work in the U.S.?*

Yes
No

(Proof of identity and legal authority to work in the U.S. is a condition of employment.)

Were you ever discharged by any company?*

Yes
No

List*

If yes, give name of company(ies) and date(s):	Reason for discharge:

Have you ever been convicted of a crime(s) other than a minor traffic violation?*

Yes
No

If yes, please explain offense(s), final disposition(s) and date(s):*

VARIOUS FEDERAL, STATE AND LOCAL LAWS PROHIBIT DISCRIMINATION BASED ON RACE, COLOR, SEX, RELIGION, NATIONAL ORIGIN, ANCESTRY, AGE, DISABILITY OR MARITAL STATUS. WEDGEWOOD PIZZA IS AN EQUAL OPPORTUNITY EMPLOYER AND YOUR RESPONSE TO ANY QUESTION WILL NOT BE USED AS A BASIS FOR DISCRIMINATION, BUT WILL BE JUDGED ON ITS RELEVANCE TO THE POSITION YOU ARE SEEKING.

PLEASE READ CAREFULLY

In submitting this application for employment, I understand that an investigation may be made whereby information is obtained regarding my character, previous employment, general reputation, educational background, credit record and/or criminal history. I authorize anyone possessing this information to furnish it to Westgate Pizza Company upon request and I release anyone so authorized and Westgate Pizza Company from all liability and damages whatsoever in furnishing, obtaining or using said information.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I understand, also, that I am required to abide by all rules and regulations of Westgate Pizza Company.

I understand and agree that if employed, the employment will be “at will”. That is, either Westgate Pizza Company or I may end theemployment relationship at any time, for any reason, or for no reason. I understand that receipt of this application by Westgate Pizza Company does not imply employment and that this application and/or any other Westgate Pizza Company documents are not contractsof employment.

Applicants Signature:*

Please type your name.

Date:*

Please attach a resume if available: