Name: Address:
City: State: Zip: Telephone: I am applying for the following position: Choose One Delivery Driver (Must be 18) Pizza Maker Cashier/Phone Station Door Hanger (Pantano Location Only - $8/hr) Availability*: Full Time Part Time - From: Choose One Monday Tuesday Wednesday Thursday Friday Saturday Sunday To: Choose One Monday Tuesday Wednesday Thursday Friday Saturday Sunday *All employees must work one weekend night per week* Last School Attended: When: Degree: Teacher or Counselor: Contact Info: Last Employer: Supervisor and Contact Info: Duties: Pay Rate: Dates of Employment: Reason for Leaving: What Store are you Applying For: Choose One Broadway and Pantano Campbell and Ft. Lowell Twin Peaks and Coachline How Far Do You Live from the Store?: How will you get to work?: For Delivery Drivers Only: At time of hiring, all delivery drivers must provide the following items: Valid Driver's License Proof of Current Insurance DMV Report