OFFICE USE ONLY:           Date received:                                       Reviewed by:

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE

Mangia Pasta Pizza is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age, disability or any other criterion. We assure you that your opportunity for employment with Mangia Pasta & Pizza depends solely on your qualifications.

DATE ___________________

Name_________________________________________________________________________________

Last                                        First                                        Middle

Present address_________________________________________________________________________

Number                                  Street                      City                         State                       Zip

How long at current address _________________________

Telephone (           ) _________________________

E-mail address_________________________

Are you over 18 years of age? ____YES ____NO, if “NO”, can you provide proof of your eligibility to work? ____YES ____NO

Can you, after employment, submit verification of your legal right to work in the United States?

 ____YES _____NO.

(Proof of eligibility will be required if hired.)

Employment desired            FULL-TIME ONLY              PART-TIME ONLY             FULL- OR PART-TIME

Position applied for ________________________

(Be specific)

When are you available to start work?____________________________

Days and hours available to work  ________________________

EDUCATION

Have you ever been convicted of a felony?    ____YES ____NO

(A conviction record will not necessarily disqualify you from employment)

If yes, explain the nature of offense(s) leading to conviction(s), and how recently such offense(s) was/were committed. ___________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

REFERENCES

Please list two references other than relatives.

WORK EXPERIENCE

Please list your work experience for the past seven years beginning with your most recent job held.

If you were self-employed, give firm name. Attach additional sheets if necessary.

May we contact your present employer?  ____YES ____NO

PLEASE READ CAREFULLY

APPLICATION FORM WAIVER

As an indication that you have read and understood each sentence, please write your initials in the

spaces provided below.

·          In exchange for the consideration of my job application by Mangia Pasta Pizza, I acknowledge and agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment

relationship, either in the position applied for or any other position, and regardless of the contents of

employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist

from time to time, or other restaurant practices, shall serve to create an actual or implied contract of

employment. _____

·          I understand that the restaurant is an “at-will” employer. _____

·          “At-will” employment means that both the restaurant and I have the right to terminate the employment at

any time, with or without notice and with or without cause. _____

·          The employment at-will relationship cannot be altered except by a written instrument signed by the General

Manager of the restaurant and me, and specifically identified as an amendment to the employment at-will

relationship. _____

·          If employed, I understand that the restaurant may unilaterally change or revise their benefits, policies and

procedures and such changes may include reduction in benefits. _____

·          I authorize investigation of all statements contained in this application. _____

·          I understand that any misrepresentations in this application or any attachment, or any omission of material

fact is grounds for automatic dismissal if employed. _____

·          I hereby give the restaurant permission to contact schools, all previous employers (unless otherwise

indicated), references, and others, and hereby release the restaurant from any liability as a result of such

contact. _____

·          I understand that, in connection with the routine processing of my employment application and/or at any time

during my employment, the restaurant may obtain investigation reports about me. _____

·          Examples of investigation reports may include, but are not limited to: credit reports, reference checks,

background checks, criminal background reports, and, educational and employment verifications. _____

·          Such investigation reports may include information as to my creditworthiness, credit records, character,

general reputation, personal characteristics, and mode of living. _____

·          Upon written request from me, the restaurant will provide me with additional information concerning the

nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act. _____

Signature of applicant__________________________________________ Date: ___________________

Thank you for completing this application form and for your interest in our business.