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Employment Application

Personal Information


First Name:*


Last Name:*


Present Address:*


City:*


State:*


Zip Code:*


Permanent Address (if different):


Phone Number:*


Email Address:*


Location Applying For:*


Birthday:*


Are you authorized to work in the US?:*


Referred By:



Employment Desired


Position (Check One):




Date you can start:


Are you employed?:



If so, may we inquire of your present employer?:



Reason for leaving your last employer


Have you ever applied to this company before?:



If so, when and where?:



Are you willing to submit information for a pre-employment background screening?:*



Are you currently charged with a crime involving violence, sex, stalking, minors, theft, property damage, fraud, robbery, or drugs?:*




Former Employers


List your two most recent jobs, starting with the most recent one first.

EMPLOYER 1
Date (Month and Year):
Name:


Start Date:


End Date:


Position:


Reason for leaving:


EMPLOYER 2
Date (Month and Year):
Name:


Start Date:


End Date:


Position:


Reason for leaving:



General Information


Please answer the following questions to the best of your ability.

Why do you want to work for Bellagios Pizza?


Why should we pick you out of all the people we interview?


On a scale of 1-10, rate your energy level (1 being the lowest):


What are your greatest strengths? Weaknesses?


Authorization


"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information."

"I understand that Bellagios Pizza is a 'Drug-Free' Environment and that I may be subject to random, with-cause and post-accident drug testing."

"I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. I understand that employment is 'At Will', and employment may be terminated for any cause at any time."

Initials*


3-1+2=


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