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Northboro House of Pizza
BUY A GIFT CARD!
Order Online
Our Menu
Gallery
About
Location
Contact Us
Feedback
Apply On Line
APPLICANT INFORMATION
All fields with an asterisk must be filled in.
Name
*
First Name
Last Name
Today's Date
*
MM
DD
YYYY
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email Address
*
Date Available
*
MM
DD
YYYY
Desired Salary
Position Applying For
If you are applying for a Driver position, you must also fill out the Driver's Vehicle Information and Agreement Form which is the last section on this application.
Are you a citizen of the United States, or otherwise eligible to work in the United States?
*
Yes
No
If you are not a citizen of the United States, are you authorized to work in the U.S.?
*
Yes
No
Have you ever worked for this company?
*
Yes
No
If yes, please list when in the space below.
Education
Please fill in all the fields below that apply to your education. Do not answer the Education questions if education is not a requirement of the position you are seeking to be hired for.
High School
*
The name of your High School.
School Address
The address of your High School.
From
MM
DD
YYYY
To
MM
DD
YYYY
Did you graduate
*
Yes
No
Degree Earned if Applicable
College
Address
From
MM
DD
YYYY
To
MM
DD
YYYY
Did you Graduate
Yes
No
Degree Earned if Applicable
Other Types of Schooling
If applicable, please list any type of specialty or trade school you attended.
Address
From
MM
DD
YYYY
To
MM
DD
YYYY
References
Please list three professional references.
Full Name
*
First Name
Last Name
Relationship
*
How do you know this person?
Company
*
Phone
*
(###)
###
####
Full Name
*
First Name
Last Name
Relationship
*
Company
*
Phone
*
(###)
###
####
Full Name
*
First Name
Last Name
Relationship
*
First Name
Last Name
Company
*
Phone
*
(###)
###
####
Previous Employment
Please start with your most recent job. In addition to Work History, volunteer activities may be listed under Work History.
From
MM
DD
YYYY
To
MM
DD
YYYY
Company
Phone
(###)
###
####
Address
Supervisor
First Name
Last Name
Job Title
Starting Salary
$
Ending Salary
$
Responsibilities
Please list job responsibilities below.
Reason for Leaving
May we contact your previous employer for a reference?
Yes
No
Next Most Recent Job
From
MM
DD
YYYY
To
MM
DD
YYYY
Company
Phone
(###)
###
####
Address
Supervisor
Job Title
Starting Salary
$
Ending Salary
$
Responsibilities
Please list job responsibilities below.
Reason for Leaving
May we contact your previous employer for a reference?
Yes
No
Next Most Recent Job
From
MM
DD
YYYY
To
MM
DD
YYYY
Company
Phone
(###)
###
####
Address
Supervisor
Job Title
Starting Salary
$
Ending Salary
$
Reason for Leaving
May we contact your previous employer for a reference?
Yes
No
Military Service
Branch
From
MM
DD
YYYY
To
MM
DD
YYYY
Rank at Discharge
Type of Discharge
Type of Discharge (Cont'd)
If other than honorable, please explain.
Driver's Vehicle Information and Agreement (All fields must be completed to be eligible for Driver employment.)
What type of car do you own?
Please type in the year, make and model of your car. For example, 2008 Honda Civic
Driver's License Number
Expiration Date
MM
DD
YYYY
Registration Number
VIN
License Plate, Including State (E.g. MA Tags 12A•BC3)
Insurance Company
Policy Number
Type of Policy
Policy Expiration Date
MM
DD
YYYY
Amount of Liability Coverage
$
Agent's Name
First Name
Last Name
Insurance Company Mailing Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Agent's Phone Number
(###)
###
####
I have completed the above data regarding my driving record and represent that the above is complete and accurate. I understand that I must present Northboro House of Pizza with a copy of my Motor Vehicle Record (to include the past calendar year) and will be considered for the position if I HAVE NOT received more than two moving violation in the past twelve months. I also understand that if I obtain additional driving violations or my driving privileges have been suspended, revoked or restricted I must notify Northboro House of Pizza Immediately. I understand that I must Have Liability coverage while I am driving for Northboro House of Pizza and that Northboro House of Pizza is not responsible for physical damage to my vehicle. I understand that if hired, I must notify my Insurance Company that in return for wages and fees, I will be using my insured vehicle to deliver food prepared by Northboro House of Pizza. I am aware that I am responsible for any adjustments that may be added to my current premium rate and that I will assume full responsibility in the event that an accident occurs and my insurance company is not aware that I am a Delivery Driver for Northboro House of Pizza. I understand the importance of safe driving and agree to follow safety policies while working: 1) To obey all traffic laws at all times. 2) To not eat or drink while driving. 3) To never drive after consuming drugs or alcohol. 4) No persons, other than on-the-job employees and authorized personnel are permitted to ride in the vehicle while I am making deliveries. 5) To notify Northboro House of Pizza if there has been any change in the status of my auto insurance. 6) To promptly report to Northboro House of Pizza any incident involving the use of a car while I am working, whether or not it results in any injury to any person or damage to any vehicle or other property, and regardless of who I believe is at fault. 7) To drive only the insured car listed above. 8) To drive courteously and practice defensive techniques. 9) Prior to being hired by Northboro House of Pizza, I agree to provide the company with copies of the following information: My Drivers License, Registration, Insurance Policy, MVR to include the past twelve months. 10) I agree to provide Northboro House of Pizza with a copy of my MVR once a Year. I have read and understand the above DRIVER'S VEHICLE INFORMATION AND AGREEMENT. BY TYPING MY NAME BELOW, IN ACCORDANCE WITH THE ESIGN ACT OF 2000, I AGREE TO ALL OF THE TERMS AND CONDITIONS LISTED ABOVE. By printing my FULL NAME below, I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.
Thank you!
