FOX'S PIZZA   -    APPLICATION FOR EMPLOYMENT

    Pre-employment - An equal opportunity employer

.

NAME (LAST NAME FIRST) :  

STREET ADDRESS:     CITY:   

STATE:     ZIP CODE:        TELEPHONE #:

EMAIL ADDRESS:   

AGE:            TODAYS DATE:

DESIRED EMPLOYMENT:

      Position (check one or more that you are interested in: Kitchen Staff  Driver Management

       Date Available to start

      Hourly Salary Desired:     Are you employed now? YES  No

       If yes where:

      Current Employment Dates:     May we contact you current employer? Yes   No

      Have you ever worked for Fox's before? Yes     No     If yes where?    

        When?

      Reason for leaving Fox's or current employer:

     Who referred you to this Fox's?

      EDUCATION

      High School: Name/location:    Years attended:   

      Graduated: Yes No    Subjects studied:  

       College: Name/location       Years attended: 

       Graduated: Yes     No     Subjects studied:

       REFERENCES - Provide names of 3 persons not related to you and you have know for one (1) or more years.

       Name:        Address:

       Telephone #          Business:

       Years known:   

       

    Name:        Address:

       Telephone #          Business:

       Years known:   

 

     Name:        Address:

       Telephone #          Business:

       Years known:   

    SERVICE RECORD

    Branch of Service:        Discharge date/rank:

    FORMER EMPLOYMENT  - list 3 employers, starting with the most recent.

    Present employer:

    Address:        City:

     State:       Zip Code:

     Start Date:     End Date:     Job Title:

     Weekly start salary:      Weekly end salary:

     May we contact your supervisor? Yes No     Supervisor's name:

     Supervisor's phone number:   

     Description of work performed:   

     Reason for leaving:   

    PREVIOUS EMPLOYER:

     Address:        City:

     State:       Zip Code:

     Start Date:     End Date:     Job Title:

     Weekly start salary:      Weekly end salary:

     Description of work performed:   

     Reason for leaving:   

    Supervisor's name:      Supervisor's phone:

PREVIOUS EMPLOYER:

     Address:        City:

     State:       Zip Code:

     Start Date:     End Date:     Job Title:

     Weekly start salary:      Weekly end salary:

     Description of work performed:   

     Reason for leaving:   

    Supervisor's name:      Supervisor's phone:

    Have you ever been convicted of a felony in the last 5 year? Yes No

     If yes, please explain:

    Do you have a valid driver's license? Yes No

    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 any or all information concerning my previous employment."

        SIGNATURE:     DATE: