Papa Chubby's Application for Employment
Pre-Employment Questionnaire - Equal Opportunity Employer

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Email *
Date *
MM
/
DD
/
YYYY
Name (Last Name First) *
Telephone Number *
Social Security No. *
Present Address *
City *
State *
Zip Code *
Permanent Address *
City *
State *
Zip Code *
Desired Position *
Date You Can Start *
MM
/
DD
/
YYYY
Salary Desired
Are You Employed Now? *
If Employed, May We Inquire Of Your Present Employer? *
Have You Ever Applied To This Company Before? *
Where
When
MM
/
DD
/
YYYY
What High School Did You Attend? *
Years Attended *
Did You Graduate? *
What College Did You Attend? *
Years Attended *
Did You Graduate?
Clear selection
Subjects Studied
Special Training/Skills You Possess
U.S. Military or Naval Service And Rank
Most Previous Employment:
Date:  To and From
Name and Address of Employer
Salary
Position
Reason for Leaving
*
Previous Employment:
Date:  To and From
Name and Address of Employer
Salary
Position
Reason for Leaving
*
Previous Employment:
Date:  To and From
Name and Address of Employer
Salary
Position
Reason for Leaving
*
Previous Employment:
Date:  To and From
Name and Address of Employer
Salary
Position
Reason for Leaving
*
References:
Name
Address
Business
Years Known
References:
Name
Address
Business
Years Known
References:
Name
Address
Business
Years Known
Authorization:
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

I understand that a consumer credit report or criminal records check may be necessary prior to my employment.  If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports.  I also understand that a poor credit history or conviction will not automatically result in disqualification from employment."

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.
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