AN EQUAL OPPORTUNITY EMPLOYER
Barro’s Pizza provides employment opportunities without regard to race, color, religion, sex, national origin, age, handicap, or veteran status.
APPLICATION FOR EMPLOYMENT
IMPORTANT: Please fill in your response above each line unless otherwise indicated. All answers must be printed or typed. Answers that are illegible or
incomplete may prevent us from considering your application.
PERSONAL DATA
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FIRST NAMEMIDDLELASTSOCIAL SECURITY #
_____________________________________________________________________________________
PRESENT ADDRESS IN FULLCITY STATE ZIPTELEPHONE
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ARE YOU LEGALLY AUTHORIZED |
YOUR VISA TYPE IF AVAILABLE |
VISA # AND EXPIRATION DATE |
TO WORK IN THE UNITED STATES? |
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|
VALID DRIVERS LICENSE? |
Yes |
No LICENSE NUMBER: _______________ STATE: ______ EXP DATE: _________ |
I AM 18 YEARS OR OLDER? |
Yes |
No |
|
HAVE YOU EVER BEEN CONVICTED OF OR SENTENCED FOR ANY VIOLATION OF THE LAW? Yes |
No |
IF YES, GIVE FULL PARTICULARS. (A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT):
_______________________________________________________________________________________________________________________________
POSITION INFORMATION
POSITION APPLIED FOR: ________________________REFERRAL SOURCE - _______________________________
WILLING TO WORK ANY SHIFT, INCLUDING NIGHTS AND WEEKENDS? Yes No HOW SOON CAN YOU START? _______________
EVER BEEN EMPLOYED BY THE COMPANY? Yes No IF YES, WHEN? ___________WHERE? __________POSITION? _______________
RELATIVES, INCLUDING IN-LAWS, EMPLOYED AT THE COMPANY? Yes No
IF YES, GIVE NAME, RELATIONSHIP, POSITION AND LOCATION:_________________________________
EMPLOYMENT HISTORY
ADDITIONAL EMPLOYMENT MAY BE LISTED ON A SEPARATE PAGE(S)
PRESENT OR MOST RECENT EMPLOYER
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FULL NAME OF COMPANYTELEPHONEWAGE -BEGIN/END EMPLOYED - FROM/TO
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STREET ADDRESSCITYSTATEZIP CODE
____________________________________________________________________________________
NAME & TITLE OF SUPERVISORTITLE OF YOUR POSITION
______________________________________________________________________________________________________________________________
DUTIES |
REASON FOR LEAVING |
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updated 2012_08_22 |
PREVIOUS EMPLOYER
_____________________________________________________________________________________
FULL NAME OF COMPANYTELEPHONEWAGE -BEGIN/END EMPLOYED - FROM/TO
_____________________________________________________________________________________
STREET ADDRESSCITYSTATEZIP CODE
____________________________________________________________________________________
NAME & TITLE OF SUPERVISORTITLE OF YOUR POSITION
______________________________________________________________________________________________________________________________
DUTIESREASON FOR LEAVING
HAVE YOU EVER BEEN SUSPENDED, PLACED ON PROBATION, ASKED TO RESIGN, DISCHARGED. OR TERMINATED? Yes No IF YES, PLEASE EXPLAIN:______________________________________________________________________________________________________
EDUCATION
SKILLS
LIST ANY OTHER SKILLS YOU THINK MAY BE OF VALUE TO THE COMPANY
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
APPLICANT'S CERTIFICATION AND AGREEMENT
I HEREBY CERTIFY that my answers to the foregoing questions are true and complete and that I have not knowingly withheld any facts, circumstances or other information which would, if disclosed, affect my application. I further understand that any false or misleading statement or omission of pertinent information will result in the rejection of my application, or in dismissal if discoved subsequent to my employment.
I HEREBY AUTHORIZE the Company to request, and I ALSO AUTHORIZE AND REQUEST each former employer, school attended, and each person, firm, or corporation given as references above, to furnish at any time, any information which may be sought concerning me and my work habits, character or skill, and any other data required, whether in connection with this application or for purposes of complying with surety company requirements or otherwise.
I HEREBY AFFIRM that by submitting this application I agree to submit to medical evaluations and/or examinations, including tests for the presence of illegal drugs or alcohol, prior to and during employment, within a time period prescribed by the Company and as often as directed during employment.
I HEREBY AUTHORIZE the medical examiner to disclose to the Company any and all findings and conclusions arrived at in any examination performed either prior to employment or during employment.
I UNDERSTAND that should I be given employment, such employment shall be for an indefinite period of time and may be terminated, at will, at anytime, for any reason, by me or by the Company without notice or without liability whatsoever, except for unpaid wages or salary earned by the date of termination.
I UNDERSTAND that if I am employed, the terms and conditions of my employment will be governed by this application and the Company's Terms of Employment and Policy and Procedures, as amended from time to time by the Company.
Signature ________________________________________ Date ________________
Thank you for completing this application. It will remain under consideration for six months. It will not be necessary for you to reapply during this six month period. Your interest in BARRO’S PIZZA is appreciated.
updated 2012_08_22
