• APPLICATION FOR EMPLOYMENT
• Manco & Manco considers qualified applicants for employment without regard to race, color, creed, religion, sex, national origin, age, marital status, ancestry, sexual orientation, medical condition or disability, or any other basis prohibited by law.
• Date
   -Month -DayYear

  2 digit month, 2 digit day, 4 digit yearDate
• PERSONAL INFORMATION
• First Name*
• Middle Name
• Last Name*
• Address*
• City*
• State*
• Zip*
• Home Phone*
• Cell Phone
• Email Address*
• Social Security Number (please do not include the dashes)*
• Are you 18 or older?*
  YesNo
• If you are under 18 years of age, can you furnish a work permit?*
  YesNo
• If hired, do you have a reliable means of transportation to get to work?*
  YesNo
• Describe
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• EMPLOYMENT DESIRED
• Position you are applying for:*
• Hours Desired*
  Full-timePart-timeSubstituteSeasonal
• Date Available to start:*
   -Month -DayYear

  2 digit month, 2 digit day, 4 digit yearDate
• If seeking seasonal work, are you available through Labor day?*
  YesNo
• If no, then to what date?
   -Month -DayYear

  2 digit month, 2 digit day, 4 digit yearDate
• Have you previously worked for Manco & Manco’s?*
  YesNo
• If yes, under what name?
• If yes, what position
• If yes, what dates? From
• To
• If the job you are applying for requires driving:
• Driver’s License Number
• State of Driver’s License:
• Expiration Date
   -Month -DayYear

  2 digit month, 2 digit day, 4 digit yearDate
• What hours and shifts(s) would you prefer to work?*
• Are you willing to work overtime?*
  YesNo
• Weekends?*
  YesNo
• Holidays*
  YesNo
• List any friends or relatives employed by this company
• Have you ever been discharged or asked to resign from any position?*
  YesNo
• If yes, please describe:
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• EDUCATION/TRAINING
• Highest Level Completed:*
  Less than High School DiplomaHigh School School Diploma Diploma/GEDAssociate"s DegreeBachelor"s DegreeMaster"s DegreePh.D.
• Name of High School
• Address
• Major
• # Years Attended
• Name of College/University
• Address
• Major
• # Years Attended
• Other Training/Education
• Address
• Major
• # Years Attended
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• WORK HISTORY
• Please list all current/previous employers, beginning with most recent
• Current/Last - Employer"s Name*
• Telephone Number*
• Address*
• Supervisor"s Name*
• Position Held
• Dates of Employment (From - To)
• Hourly Pay Rate
• Reason for Leaving
• May we contact?
  YesNo
• Describe your job responsibilities
• Previous- Employer"s Name
• Telephone Number
• Address
• Supervisor"s Name
• Position Held
• Dates of Employment (From - To)
• Hourly Pay Rate
• Reason for Leaving
• May we contact?
  YesNo
• Describe your job responsibilities
• Previous - Employer"s Name
• Telephone Number
• Address
• Supervisor"s Name
• Position Held
• Dates of Employment (From - To)
• Hourly Pay Rate
• Reason for Leaving
• May we contact?
  YesNo
• Describe your job responsibilities
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• PERSONAL
• Have you ever been known by any other name(s)?*
  YesNo
• If yes, what names?
• Can you perform the tasks of the position for which you are applying with or without a reasonable accommodation?
  YesNo
• If no, please explain
• Are you legally entitled to work in the United States?*
  YesNo
• If you are hired by Manco & Manco, The Immigration Reform Act of 1986 requires you to provide certain information, including date of birth and country of origin, and to attest to your employment eligibility. In addition, you will be required to produce documents establishing your identity and work authorization.
• Please describe any skills, training or qualifications you have which are relevant to the job you are applying for (i.e., computer skills, restaurant training):
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• EMPLOYER/PROFESSIONAL REFERENCES
• Name
• Title
• Phone number (s)
• Organization
• Address
• Name
• Title
• Phone number (s)
• Organization
• Address
• Name
• Title
• Phone number (s)
• Organization
• Address
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• PLEASE READ CAREFULLY
• APPLICANT’S CERTIFICATION/AT-WILL EMPLOYMENT: I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements shall be considered cause for dismissal. I also understand that if I am hired for employment, I am required to abide by the rules and policies of Manco & Manco. I further agree to immediately notify Manco & Manco if I should be convicted of a crime while my job application is pending or during my employment, if hired. I also understand that a background check may be performed on me as set forth in the separate document entitled Background Check Disclosure and Authorization for Release of Records that is enclosed separately with this application for my review and signature. I release, indemnify and hold harmless Manco & Manco from and against any and all liability which might result from making such an investigation. I further understand that this employment application and any other organization documents are not contracts of employment, and that any individual that is hired may voluntarily leave employment, and may be terminated by the employer at any time for any reason. I understand that any oral or written statements to the contrary are expressly disavowed and should not by relied upon by any prospective or existing employee. I also understand that the use of this application does not necessarily indicate that there are any positions open and does not obligate Manco & Manco in any way. It is understood employment is predicated on passing any applicable pre-employment examinations. 
• Signature (please use your initials)*
• Date*
   -Month -DayYear

  2 digit month, 2 digit day, 4 digit yearDate
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• EMPLOYMENT REFERENCE RELEASE:
• I authorize my prior and current employer to release all information (including opinion information) regarding my employment with them. I hereby release and hold harmless any individual and company which is providing this information to Manco & Manco from any legal liability for any damages that may result from the disclosure of this information.
• Signature (please use your initials)*
• Date*
   -Month -DayYear

  2 digit month, 2 digit day, 4 digit yearDate
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• BACKGROUND CHECK DISCLOSURE & AUTHORIZATION FOR RELEASE OF RECORDS
• IMPORTANT - PLEASE READ AND SIGN THE FOLLOWING: I am applying for employment with Manco & Manco Pizza. I acknowledge that I have been notified by Manco & Manco Pizza that it may obtain my consumer report in connection with this application and, if I am offered employment, may obtain consumer reports during my employment. A “consumer report” is defined as any written, oral or other communication of any information by a consumer reporting agency bearing on a consumer’s credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. This information may include, but not be limited to: verification of identification and/or social security number; checks of criminal history, if any; and verification of any licenses held. I understand that this information may be used to evaluate me for possible and/or continued employment. The Fair Credit Reporting Act entitles me to know if an adverse employment decision is made based on this information obtained from a Consumer Reporting Agency. If any adverse employment decision is made based on this information, I will be advised. I will also be given the name of the agency or source which provided the information, a copy of the information and a summary of my rights under the Fair Credit Reporting Act. By my signature below, I authorize Manco & Manco Pizza to obtain a consumer report from any consumer reporting agency in order to consider me for possible and/or continued employment.
• Signature (please use your initials)*
• Date*
   -Month -DayYear

  2 digit month, 2 digit day, 4 digit yearDate
• Submit
• Should be Empty: