Pizza hut

Employment Application
Applicant Information
Full Name:

clark

craig

Last

Address:

Date:2/22/2016

First

M.I.

453 merrywood dr
Street Address

Phone:

Apartment/Unit #

Birmingham

alabama

35214

City

State

ZIP Code

205-720-6955

Date Available:

Asap

EmailCraigclark@jcboe.k12.al.us
Social Security No.:7206955

Desired Salary:$ 10.50

Position Applied for: Delivery driver

Are you a citizen of the United States?
Have you ever worked for this company?
Have you ever been convicted of a felony?

YES

NO

YES

NO

YES

NO

If no, are you authorized to work in the U.S.?

If yes, when? No

If yes, explain:

Education
High School:
From:

2015

Minor high school

To:

Address:2285 minor pkwy Adamsville al 35005

Did you graduate?

College:
From:

NO

YES

NO

YES

NO

Diploma::

Address:
To:

Did you graduate?

Other:
From:

YES

Degree:

Address:
To:

Did you graduate?

References
Please list three professional references.
1

Degree:

YES

NO

Full Name: Mrs. Cottrell

Relationship: Teacher

Company:

Minor high school

Address:

2285 minor pkwy Adamsville

Phone:205-456-7895

Full Name: Mr. Frazier

Relationship: Teacher

Company:

Minor high school

Address:

2285 minor pkwy Adamsville

Phone:205-568-2358

Full Name: Mrs. Green

Relationship: Teacher

Company:

Minor high school

Phone:205-451-5695

Address:

2285 minor pkwy Adamsville

Previous Employment
Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

NO

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

NO

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

2

Ending Salary:$

YES

May we contact your previous supervisor for a reference?

NO

Military Service
Branch:

From:

Rank at Discharge:

To:

Type of Discharge:

If other than honorable, explain:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or
interview may result in my release.
Signature:

Craig clark

Date:2/22/2016