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To be considered for employment at Krimmer's Italianette Pizzeria, we ask that you complete the application below to the best of your ability and press the submit button once you are done. We will review your application and a member of Italianette Pizzeria will contact you in a timely manner to discuss any career opportunities that we may have available. Please note that fields marked with an asterisk (*) are required for Italianette's management to contact you. PERSONAL INFORMATION Desired Position:* Cook Counter/Cashier Driver Server Busser Manager Hours:* Full Time Part Time Anytime Days and Times Available: Mon. Tues. Wed. Thurs. Fri. Sat. Sun. Day Day Day Day Day Day Day Eve. Eve. Eve. Eve. Eve. Eve. Eve. Name: * Address: * City: * State: * Zip Code: * Telephone: * Are you under 18?: Yes No * If Yes, Date of Birth: Are you legally entitled to work in the United States? Have you ever worked at Italianette Pizzeria? Yes Yes No No * If yes, when? If you were told about this position from an Italianette employee, who referred you? GENERAL INFORMATION Referred By: Name of Relatives Employed Here: Position Desired: * Start Date: * Salary Desired: PAST EMPLOYMENT Are You Employed Now?: Yes No May We Contact Your Present Employer?: * Yes No Have You Ever Applied at Italianette Pizzeria Before?: Do You Have Any Physical Limitations?: Yes Yes No If Yes Explain: Past Employer #1: * Address: Position (Duties): * Phone: May we Contact?: Starting Pay: Yes No * Ending Pay: Dates Employed: Reason for Leaving: Past Employer #2: * Address: Position (Duties): Phone: * No * May we Contact?: Yes Starting Pay: No Ending Pay: Dates Employed: Reason for Leaving: Past Employer #3: * Address: Position (Duties): * Phone: May we Contact?: Yes Starting Pay: No Ending Pay: Dates Employed: Reason for Leaving: Have you ever been convicted or plead guilty to a criminal offense? * Yes No If yes, please explain when, where and facts surrounding offense: EDUCATION Name Dates Attended Date Completed High School College/Tech REFERENCES In the box below list 3 references not related to you that you have known at least 1 year. Name Relationship Telephone DELIVERY DRIVERS ONLY If you are employed by Krimmer Italianette Pizzeria as a delivery driver then you are required to provide proof of personal auto liability insurance and drivers' license. In addition, your motor vehicle report will be checked at the time of application and periodically thereafter to verify your driving eligibility. We will need your date of birth to run an MVR report. *Date of Birth: You are responsible for maintaining any costs incurred on your car while employed here. Krimmer Italianette Pizzeria will not be held responsible for any loss, theft or damage to your vehicle and its contents while employed. Minimum age requirement is 18. Insurance Company: * Policy Expiration Date: Drivers License #: State License Issued: Date License Issued: Do you have at least 1 year driving experience? Have you been in an accident in the past 3 years? Yes Yes No No * Explain: Any speeding tickets/violations in the last 3 years? Yes No * Explain: Has your license ever been suspended/revoked? Yes No Explain: Vehicles to be used on the job: Make Model Year License# State By clicking the submit button, you agree to the following: Krimmer Italianette Pizzeria is an equal opportunity Employer. Any person applying for a position will be considered without regard to race, religion, sex, age, national origin, or disability. I certify that all statements made in this application are true and complete. I authorize Krimmer Italianette Pizzeria to investigate all statements made by former employers, references, and law enforcement agencies. I further authorize Krimmer Italianette Pizzeria to conduct whatever background checks are necessary to verify information provided by me or in interviews relating to my employment. In the event that my employment is rejected or terminated based on a report received from such a background check, I understand I will receive a full copy of such a rep ort within 60 days and will have an opportunity to dispute the accuracy of the information included in the report. I understand that any false information made by me on this application will be sufficient for a rejection of my application, or for my immediate termination if should one discover after I am employed. I understand that nothing in this employment application is intended to create an employment contract with Krimmer Italianette Pizzeria, and that my employment with this company is entered into voluntarily, that I may resign at any time, and that my employment may be terminated at any time without prior notice. I hereby acknowledge that I have read and understand the preceding statement. Type Your Name: Date: Submit