Zachary's Chicago Pizza - Pleasant Hill - Cook

First name

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Last name

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Phone number (Mobile preferred)

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Street Address/City/Zip Code:

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Are you legally eligible to work in the US?

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If hired, do you have reliable transportation to get to and from work?

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Have you ever applied to Zachary's before? If so, when?

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How did you hear about the job?

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If hired, what date can you start?

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How many days per week are you interested in working?

3 days per week

4 days per week

5 days per week

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Are you looking for a:

Full-time Position

Part-time Position

Seasonal Position

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If hired, how long do you anticipate working for Zachary's?

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Do you have any previous commitments or engagements (vacations, weddings, travel) that will require time off from work? If yes, please provide details.

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Do you expect any changes to your availability in the next year? If yes, please provide details.

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Please list your work experience, starting with most recent. Please provide the following information for each: 1) Dates of employment, 2) Company Name and Location, 3) Your Position/Duties 4) Supervisor Name and Contact Info, 5)Reason for Leaving

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Are you currently employed?

Yes

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If you are currently employed, may we contact your present employer?

Yes

N/A

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Have you ever been dismissed or forced to resign from employment?

Yes

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If you have ever been dismissed or forced to resign from employment, please explain.

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*CERTIFICATION*

All persons shall have equal employment opportunities with Zachary's Chicago Pizza, Inc. ("Zachary's Pizza") regardless of race, color, creed, religion, national origin, ancestry, sex, marital status, sexual orientation, disability, age and any other legally protected class and within the framework of federal law regarding age discrimination, employment of the handicapped and Vietnam era veterans. Employment shall be based solely on the Company's need and the individual's qualifications. I certify that I have completed this application and the statements I have made in this application are true and complete. I authorize investigation of all statements contained in this application which Zachary's Pizza may deem relevant to my employment and authorize my previous employers or other persons having information concerning my records or me to report such information to Zachary's Pizza. I hereby release Zachary's Pizza, my former employer or other persons who may provide information from any liability as a result of providing such information. I understand and agree that if it is subsequently discovered that the information is untrue or that I have failed to disclose a material fact, any offer of employmeent made to me by Zachary's Pizza may be immediately withdrawn or if I am already employed by Zachary's Pizza, I may be subject to immediate dismissal at the option of Zachary's Chicago Pizza. In such event, the withdrawal of any offer of employment made to me or the termination of employment shall be without any obligation or liability to me by Zachary's Pizza, other than for wages at the rate agreed upon for work I have actually performed for Zachary's Pizza. If I become employed, in consideration of my employment, I understand that I must comply with the rules, regulations, and policies and procedures of the the company. I am aware of and understand the physical requirements of the job and certify that I can and will perform these requirements in a safe manner, with or without accommodation. In accordance with the Immigration and Control Act of 1986 Zachary's Pizza will only hire United States citizens and aliens lawfully authorized to work in the United States. I understand that I will be required to complete the designated employment verification I-9 Form as a condition of employment. I understand that I may be required to undergo drug testing and/or a background check and that my employment is contingent upon these results. I will be advised if this is required and complete the necessary authorizations. I understand that I am not obligated to disclose sealed or expunged records of conviction or arrest, nor may Zachary's Pizza ask me if I have had records sealed or expunged. I understand and agree that if I am employed as a result of this application, my employment will be at-will, which I understand means that I will not be employed for any definite period of time and that my employment may be terminated at any time. At-will employment may only be modified by a written agreement signed by an Officer of the Company.

I understand and agree to the above "Certification" statement. I understand and agree that typing my name below* will act as my electronic signature.

Yes No

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Signature of Certification* (Include Full Name)

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Upload resume (Optional)

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