Passport Pizza Employment Application

(586) 247-0000

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Employment Application

(Please allow yourself enough time to fill out this application.)

General Information
First Name:		Last Name:
Position Desired:	(Hold the "CTRL" key to make multiple selections)
Email :
Address :
City:
State:
Zip Code:
Phone :			Age (Optional if over 18)
If Applying for Driver Position, Please fill out the blue area below.
Driver License #			State Issued
Expiration Date			Insurance Company and Policy #
Desired starting salary
Have you ever been convicted of a felony or are there felony charges pending against you? Yes No
If Yes, Please explain
Are you able to perform all of the essential functions and duties required of the position for which you are applying for? Yes No
If No, Please explain how you would perform these essential functions and/or duties with or without reasonable accommodations
In case of emergency, please contact : Name Relationship
Emergency Contact: Home Phone Cell Phone
Employment History Employer #1 (most recent) Dates worked (From- To) Please list Employer #1's Company name, Address, and Supervisor Position Reason for Leaving
Employer #2 (2nd most recent) Dates worked (From- To) Please list Employer #1's Company name, Address, and Supervisor Position Reason for Leaving
Education Name of High School Please select one
Name of College or Trade School Degree or Certificate Level
Additional Comments :
By checking this box, you agree that all of the information entered into this form is true to the best of your knowledge. This Application cannot be sent unless you check the box in the upper left corner of this section!