Welcome to Village Pizza, Rochester / Gonic  ●  49 Hancock Street, Rochester, NH  ●  Call: (603) 335-4344

First Name

M

Last Name
Current Address
City
 ,		 State
 		Zip
Day Phone
 		Evening Phone
  
Email
      How did you hear about us?  
 Newspaper
  School/College
  Website
 Friend/Relative
 
 Other
 
Compensation Requirements
 a		 Date Available
 
Have you ever worked for or known anyone that has worked for Village Pizza?  No  Yes  
If hired, can you provide proof that you are over the age of 18 and eligible to work in the United States?  No  Yes  
Are you currently employed?  No  Yes  
May we contact your present employer?  No  Yes  
Have you been convicted of a felony within the past seven years?  No  Yes  
Have you ever been convicted of, pled guilty or "no contest" to or had any unresolved charges related to a criminal offense involving dishonesty or a breach of trust such as fraud, theft, forgery or other similar crimes?  No  Yes  
Do you have any commitments to another employer, such as a non-compete or non-disclosure agreement that may affect your employment with Village Pizza?  No  Yes  
     
Education
School and Location

Course of Study

Years Completed

Diploma/Degree
High School:

9  10  11  12 

College or University:

1  2  3  4 

Graduate or Professional:

1  2  3  4 

Other: (self education, seminars, volunteerism, military training, special language abilities, memberships of professional organizations, etc.)
     
References
Provide name, address, and telephone number of three professional references (i.e. previous employers and/or supervisors).
Name:
 		Address:
 		Phone:
Name:
 		Address:
 		Phone:
Name:
 		Address:
 		Phone:
     
Employment Experience
Please fill out this section completely.  Begin with your most recent employer.
   
Company Name:
 		Employed From:
 		Starting Position:
 		Starting Salary:
Address, City, State, Zip Code:
 		Employed to:
 		Ending Position:
 		Ending Salary:
Supervisor:
 		 Phone Number:
Reason for Leaving:
 
 
Responsibilities:
Employment Experience
Please fill out this section completely. 
   
Company Name:
 		Employed From:
 		Starting Position:
 		Starting Salary:
Address, City, State, Zip Code:
 		Employed to:
 		Ending Position:
 		Ending Salary:
Supervisor:
 		 Phone Number:
Reason for Leaving:
 
 
Responsibilities:
Employment Experience
Please fill out this section completely.  \
   
Company Name:
 		Employed From:
 		Starting Position:
 		Starting Salary:
Address, City, State, Zip Code:
 		Employed to:
 		Ending Position:
 		Ending Salary:
Supervisor:
 		 Phone Number:
Reason for Leaving:
 
 
Responsibilities:

  • I certify that my statements on this application are true and complete to the best of my knowledge. I further understand and agree that any misrepresentation or omission by me on this form will result in the cancellation of further consideration or termination of my employment.

  • I authorize Village Pizza to investigate information concerning my previous employment, education and training. I hereby hold harmless from liability all persons on account of such disclosure. I understand that the investigation may include verification of past employment, education, driving record, conviction criminal history, and review of personnel records maintained by any prior employer including opinions of reference.

  • I understand and agree that, if hired, my employment is at will, it is for no definite period of time, and may be terminated at any time.

  • I hereby acknowledge that I have read the above statements and understand and agree to what I have read.

   

© Village Pizza