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Pre-Screen
Basic questions and referral source.
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| PROOF OF AGE MAY BE REQUIRED. SNACK BAR ATTENDANT APPLICANT: Are you 18 years or older? |
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| Referral Source |
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NOTE TO ALL APPLICANTS: This application will be considered active for 30 days from the date that you sign it.
After that time, you must complete a new application to be considered for future job openings.
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Personal Information
Contact details and address.
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| Phone Number |
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| First Name |
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| Last Name |
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| Address Street |
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| APT/Unit |
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| City |
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| State |
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| Zip |
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Work Eligibility
Permits, prior applications/employment, and right-to-work.
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| Are You Old Enough To Work Without A Permit? |
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| If Not Can You Furnish A Permit? |
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| Have You Applied Here Before? |
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| If Yes, Provide Date |
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| Have You Ever Been Employed by Pinboy’s Before |
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| If Yes, Provide Date |
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| May We Contact Your Previous Employer |
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| If Yes Employer Phone Number |
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| Are You Legally Eligible For Employment In This Country? (Proof Of U.S. Citizenship Or Immigration Status Will Be Required Upon Employment.) |
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| On What Date Would You Be Available To Work? |
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Background
Felony question and explanation.
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| Have You Been Convicted of a Felony in the Last Seven (7) Years |
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| (Such Conviction May Be Relevant If Job Related, But Does Not Bar You From Employment.) If Yes, Please Explain: |
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Military & Accommodations
Optional information.
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| Are You a Veteran of The U. S. Military |
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| Do You Require Reasonable Accommodations for the Job for Which You Are Applying |
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Skills & Qualifications
List any special job-related skills.
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| Special Skills and Qualifications: List Any Special Job-Related Skills And/or Qualifications Acquired from Employment or Other Experience |
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References
List Names And Telephone Numbers Of (2) Business/Work References Who Are Not Related To You And Are Not Previous Supervisors.
If Not Applicable, List Two (2) School Or Personal References Who Are Not Related To You.
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| Name |
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| Telephone |
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| Years Known |
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| Name |
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| Telephone |
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| Years Known |
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Employment Experience
Please list last three (3) employers.
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1st Employer |
| Employer | |
| Address | |
| Supervisor | |
| Your Job Title | |
| Dates Employed | |
| Work Performed | |
| Hourly Rate | |
| Reason For Leaving | |
2nd Employer |
| Employer | |
| Address | |
| Supervisor | |
| Your Job Title | |
| Dates Employed | |
| Work Performed | |
| Hourly Rate | |
| Reason For Leaving | |
3rd Employer |
| Employer | |
| Address | |
| Supervisor | |
| Your Job Title | |
| Dates Employed | |
| Work Performed | |
| Hourly Rate | |
| Reason For Leaving | |
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Certification & Signature
Please read and sign.
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I as applicant 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.
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I authorize investigation of all statements contained herein and the references above to give you any and all information concerning my previous employment and any pertinent information they may have, personal and otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
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I understand and agree, if hired, that any employment relationship with this company is of an "at will" nature, which means the employee may resign at any time and the employer may discharge at any time, with or without cause. I understand this is an application and that no employment contract is being offered.
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| Applicant Signature (Type Your Name): |
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| Date |
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