Employment Application Thanks for your interest in Mary's Pizza Shack! This form should only be used if you wish to apply to our location in Rohnert Park.Personal InformationLast Name* First Name* Middle Name Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code Phone Number*Email Address Are you over 18 years of age? Yes No Employment DesiredThis form may only be used to apply for positions in the Rohnert Park location.Position Desired Desired Wage Date You Can Start MM slash DD slash YYYY Shifts you are UNABLE to work Monday Day Monday Night Tuesday Day Tuesday Night Wednesday Day Wednesday Night Thursday Day Thursday Night Friday Day Friday Night Saturday Day Saturday Night Sunday Day Sunday Night I can work any shift Please select shifts that you are unable to work. Keep in mind that hours may vary.How did you learn about us?AdvertisementWalk-inFriendFamilyEmployment AgencyWhat do you like about the food industry?Why would you like to work for Mary's Pizza Shack?EducationHigh SchoolName and Address of High SchoolYears Completed-None-1234Did You Graduate? Yes No Subjects StudiedCollegeName and Address of CollegeYears Completed-None-1234Did You Graduate? Yes No Subjects StudiedFormer EmployersList below current and last three employers, starting with the most recent one first. Please include any non-paid/volunteer experience which is related to the job which you are applying.Most Recent EmployerDate Started Date Ended Name and Address of EmployerWage Position Reason For Leaving Duties Performed Supervisor's Name Phone Number May We Contact? Yes No Additional Previous Employer? Yes No Previous EmployerDate Started Date Ended Name and Address of EmployerWage Position Reason For Leaving Duties Performed Supervisor's Name Phone Number May We Contact Yes No Additional Previous Employer? Yes No Previous EmployerDate Started Date Ended Name and Address of EmployerWage Position Reason For Leaving Duties Performed Supervisor's Name Phone Number May We Contact? Yes No Additional Previous Employer? Yes No Previous EmployerDate Started Date Ended Name and Address of EmployerWage Position Reason For Leaving Duties Performed Supervisor's Name Phone Number May We Contact? Yes No AuthorizationAuthorization* No Yes By choosing "yes", I hereby authorize Mary's Pizza Shack to thoroughly investigate my background, references, employment record and other matters to my suitability for employment. I authorize persons, schools, my current employer (if applicable) and previous employers and organizations contacted by Mary's Pizza Shack to provide relevant information regarding my current and/or previous employment and I release all persons, schools, employers of any and all claims for providing such information. I understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up to and including dismissal. I understand that I may be required to sign a confidentiality and/or non-compete agreement, should I become an employee of Mary's Pizza Shack. I understand that nothing contained in this application, or conveyed during any interview which may be granted, is intended to create an employment contract. I understand that filling out this form does not indicate there is a position open and does not obligate Mary's Pizza Shack to hire me. I understand and agree that if hired, my employment is at will, which means that it is for no specified period and may be terminated by me or Mary's Pizza Shack at any time without prior notice for any reason.Mary's Pizza Shack is an Equal Opportunity Employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, religion, national origin, the presence of mental, physical, or disability, sexual orientation, or any other basis prohibited by federal, state, or provincial law.NameThis field is for validation purposes and should be left unchanged.
