Employment Application

Looking for a fun work environment?  FIll out our Employment Application below to get started.

"*" indicates required fields

Application for Employment • Butch's Pizza

Pre-Employment Questionnaire • Equal Opportunity Employer
Name*
Present Address*
Permanet Address if different then above

Education History

Did you graduate?

Did you graduate?

Did you graduate?

General Information

Work History - Former Employers

List below your last 4 employers, with the last one first.
Please provide Start/Finish Month & Start/Finish Year

Please provide Start/Finish Month & Start/Finish Year

Please provide Start/Finish Month & Start/Finish Year

Please provide Start/Finish Month & Start/Finish Year

References

Please give the names of 3 References not related to you, who you have known at least one year.
Name
Address

Name
Address

Name
Address

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 you any and all in­formation concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these , reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment." In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to com­plete the required employment eligibility verification document form upon hire.
MM slash DD slash YYYY
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