reso eee ‘Streak Ag ea ‘Apartment Number: iy: sae LT zpoode 6 PreneNnbe: IM] ‘Catt Phone Nuniber a {ola = | Nameot High cholate ay Naneof techer/ccunsslor to contac as areference: Nameot college attended ity ‘State. ZipCode: Wns ypeofpoatenareyousiacng: | Fu-Tire © vty Tuyen Tay Pty Steyr TY [¢[5 Ateyou leat teyarsot age? Ye) No Areyoust let 18yearsot age? Yes (iS) Areyoulepaly tietbeanpioncinneus? ©) No ‘Have you ever worked for cttage in Pizza Before? Yes @) in Date werkt Loxton: Reser lenin: ave you eer bean carck or plead guilty toafdloy ce cher than aminor rc vckion? (tyes plesseralan) Yes (No) Io ‘What postion are you apy Dale Avalabeto start work: “Toll hours avaiete par week ‘What hours reyou avallabloto work List ‘oursineach box List below your most recent employers, begining witnthamas recent ona, Compary: Aros: oo Title: Spenco Prone Nurrber: Date Starter Date Let: ‘Salary or Wage: Stat Houty Wey Yealy Sar or Wage: End, Hourly Weekly Yeaty Reason for leaving: Compary: Adkess: Sb Tie Spanier: Phone Number: Date States: DateLet Saber or Wage Start Hourly Weakly Yeaty ‘Sdlary or Wage End Hourly Weekly Yeaty Reson for levirg:How did youhoar sbout us? foal Visting our sore Refers other. (pleasospaaty) (Wee saxty) [Minimum Age Recuitement for addivay drive position Is 18. Please answer thefellowing questions you re applying for adlivery driver postion 1.Doyouhaeavaiddive’sicasd? Yes No {Ut yes) Driver's Liosnse Number Dateof sue, 2 Haveyouben cornices of or pled gully to ay vefiordaadotfensewithintbepastiveyers? Yes No 3, Haveyyouthad your civerslicanse axpancat or revoked, or had your diving privileges modified by acourtof lav? Yes NO 4, lool ll ees from which you hold or haveheld actver’s lense. 4. oartty tht | have read this aplication ad theingormation ont is complete and correct | undarsend thet ary omissions.or misxepresenttion of Informaionis rounds for isvissd. 2 | ahorize the persons, employers, schools, and organizallons listed on his application to giveyou any Information concering my employment ‘and othr pertinent information they may have pawn and otherwise and released prtiesfrom a leblty and damages that may rest from furishing this to you. wtlacdefifr Date. Vez Id / ie