PAYNESVILLE, MN
320-423-0530
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LOCATION:
Which location are you applying at?:
PERSONAL INFO:
First Name:
Middle Name:
Last Name:
Email address:
Address:
City:
State:
Zip:
Phone:
Soc Sec#:
Are you 18 or older?:
Make Selection
No
Yes
Do you have transportation?:
Make Selection
No
Yes
Currently employed?:
Make Selection
No
Yes
Date you can start:
Desired Position:
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Cook
Driver
Manager
Desired pay rate/salary:
Hours/days available:
Desired hours per week:
Have you been convicted of a crime or had a diversion in the last 7 years?:
Have you worked for a Jimmy's Pizza before?:
Make Selection
No
Yes
If yes, please list dates, location, supervisor and reason for leaving:
EDUCATION:
High School: School name, city and grade completed:
Graduation Date:
Current College: School name, city and grade completed:
Graduation Date:
School Achievements/Awards:
OTHER:
List any activities, hobbies or interests outside of work:
DRIVER APPLICANTS:
You must meet our Safe Driver Policy. Your MVR will be run prior to hiring and every 6 months.
Driver's License #:
License State:
License Expiration:
Insurance company:
Policy #:
Policy effective dates:
Liability amount:
EMPLOYMENT HISTORY:
List 2 most recent positions held starting with most with recent employer first:
Most recent employer
:
Employer name:
Start date:
End date:
Starting wage:
Ending wage:
Reason for leaving:
Type of business:
Position held:
Eligible for rehire?:
Make Selection
No
Yes
Supervisor name:
Employer phone:
May we contact?:
Make Selection
No
Yes
Previous employer
:
Employer name:
Start date:
End date:
Starting wage:
Ending wage:
Reason for leaving:
Type of business:
Position held:
Eligible for rehire?:
Make Selection
No
Yes
Supervisor name:
Employer phone:
May we contact?:
Make Selection
No
Yes
Please be sure you have filled out the application completely in order to ensure timely processing.
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