Application for employment

First Name:
Middle Name:
Last Name:
Phone Number:
Email:
Address:
City:
Zip Code:
Social Security Number:
Position Applied for:
Full or Part time:
Have you previously been employed by Hemi's Pizzas?
If Yes, when?

Have you previously applied for employment at Hemi's Pizza?

If so, when?

EMPLOYMENT HISTORY (Most recent first)
Employer:
Position:
From: To:
Contact:
Phone:
Salary:
Reason for Leaving:
Employer:
Position:
From: To:
Contact :
Phone:
Salary::
Reason for Leaving:
Employer:
Position:
From: To:
Contact :
Phone:
Salary:
Reason for Leaving:
EDUCATION
High School:
Year Graduated:
Major
College:
Year Graduated:
Major:
Other Education or Training:
EMERGENCY INFORMATION
In case of emergency, notify:
Phone Number:
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, false statements on this application may be grounds for dismissal.
I authorize investigation of all statements contained herein. I further authorized references to give you any and all information concerning my previous employment and any other pertinent information they have.
I understand and agree that, if hired, my employment is for no definite period and either I, or the Company, can terminate the employment relationship at any time, with or without cause, with or without notice.
Date: Initials:
Please fill out the following if you are applying for a driving position
Current Driver License Number:
State:
If less than two years, Previous:
State:
Insurance Company:
Policy Number:
Policy Effective Date:
Policy Expiration Date:
I verify that I have at least 2 years; uninterrupted driving history in the U.S.A.
I authorize Hemi’s Pizza to obtain a current Motor Vehicle Record, and that my record may be verified periodically at the company’s discretion. I understand that if my record does not meet company requirements at any time my employment may be terminated.
I understand that I must have liability coverage for the vehicle I am driving for Hemi's Pizza and that Hemi's is not responsible for physical damage to the vehicle I am driving, whether registered to me or someone else.
I understand the importance of safety and agree to the following safety policies while working:
To obey all traffic laws at all times and exercise all safety measures while driving.
To wear my safety belt at all times.
Not to eat or drink while driving.
To never drive after having consumed alcohol or drugs.
To promptly notify Hemi's Pizza. when I have received a ticket or have been arrested for any driving-related offenses.
To promptly notify Hemi's Inc. when my driving privileges have been revoked, suspended, or restricted.
To promptly notify Hemi's Inc. when there has been any change in my car insurance, including renewal expiration dates.
To always drive safely, courteously and practice defensive driving techniques.
To promptly report to Hemi's Inc. any incident involving the use of a car while I am working whether or not it results in any injury or damage, and regardless of who I believe is at fault.
To maintain the vehicle I drive in safe condition in compliance with all State and Federal requirements.
No persons other than on-the-job employees and authorized personnel are permitted to ride in my delivery vehicle while making deliveries for Hemi's.
I have read and understand the above employment agreement.
Initials:
Date:
Hemi's Pizza Work Application via web.

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