APPLICANTS ARE CONSIDERED FOR EMPLOYMENT WITHOUT REGARD TO THEIR RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE, MARITAL STATUS, VETERAN STATUS, CITIZENSHIP, HANDICAP, DISABILITY OR ANY OTHER REASON PROHIBITED BY FEDERAL OR VIRGINIA ANTI¬DISCRIMINATION LAW. INQUIRIES AS TO AGE ARE MADE IN GOOD FAITH FOR NON-DISCRIMINATORY PURPOSES IN COMPLETING THE FORM.

PROOF OF AGE MAY BE REQUIRED. SNACK BAR ATTENDANT APPLICANT: Are you 18 years or older?
POSITION(S) APPLIED FOR:
REFERRAL SOURCE:

NOTE TO ALL APPLICANTS: This application will be considered active for 30 days from the date that you sign it. After that time, you must complete a new application to be considered for future job openings.

TELEPHONE NUMBER:
Frist Name:
Last Name:
ADDRESS: STREET:
APT/UNIT:
CITY:
STATE:
ZIP:
Are you old enough to work without a permit?
If not, can you furnish a work permit?
Have you filed an application here before?
If YES, please provide date:
Have you ever been employed by Pinboy’s before?
If YES, please provide date:
Are you employed now?
If YES Current Employer:
May we contact your present employer?
IF YES, EMPLOYER PHONE NUMBER:
Are you legally eligible for employment in this country? (Proof of U.S. Citizenship or immigration status will be required upon employment.)
On what date would you be available to work?
Have you been convicted of a felony in the last seven (7) years?
(Such conviction may be relevant if job related, but does not bar you from employment.) If YES, please explain:
Are you a veteran of the U. S. Military
Do you require reasonable accommodations for the job for which you are applying?
Special Skills and Qualifications: List any special job-related skills and/or qualifications acquired from employment or other experience:

List Names and telephone numbers of (2) business/work references who are not related to you and are not previous supervisors. If not applicable, list two 2 school or personal references who are not related to you.

NAME:
TELEPHONE:
YEARS KNOWN:
NAME:
TELEPHONE:
YEARS KNOWN:

EMPLOYMENT EXPERIENCE: PLEASE LIST LAST 3 EMPLOYERS

1st EMPLOYERS

EMPLOYER:
ADDRESS:
SUPERVISOR:
YOUR JOB TITLE:
DATES EMPLOYED:
WORK PERFORMED:
HOURLY RATE:
REASON FOR LEAVING:

2nd EMPLOYERS

EMPLOYER:
SUPERVISOR:
YOUR JOB TITLE:
DATES EMPLOYED:
WORK PERFORMED:
HOURLY RATE:
REASON FOR LEAVING:

3rd EMPLOYERS

EMPLOYER:
SUPERVISOR:
YOUR JOB TITLE:
DATES EMPLOYED:
WORK PERFORMED:
HOURLY RATE:
REASON FOR LEAVING:

I as applicant 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 above to give you any and all information concerning my previous employment and any pertinent information they may have, personal and otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree, if hired, that any employment relationship with this company is of an "at will” nature, which means the employee may resign at any time and the employer may discharge at any time, with or without cause. I understand this is an application and that no employment contract is being offered.

Applicant Signature(Type Your Name):
Date: