Please fill out ALL sections that apply to you.

(If applicable sections are left blank, the application will not be accepted.)

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* 1. Which LPC location are you applying to?

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* 2. Please enter your contact info:

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* 3. Are you entitiled to work in the United States?

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* 4. Have you been convicted of a felony or been incarcerated in connection with a crime in the past 7 years?

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* 5. If you answered "Yes" above, please explain.

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* 6. Highest level of education?

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* 7. List any special certifications or licenses that you have that apply to this job. (Serve-safe, etc.)

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* 8. How were you referred to Lost Pizza Co.

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* 9. What position/location you are applying for? 

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* 10. Military Service?

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* 11. Which Branch?

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* 12. Availability-
Are you currently employed?

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* 13. If so, where and when?

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* 14. Are you currently in school?

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* 15. If so, when are your classes?

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* 16. Expected hourly rate?

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* 17. What days/shifts are you available to work at Lost Pizza Co?

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* 18. Date available to start?

Date

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* 19. Prior Work Experience-
List Employer's info:

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* 20. Job Title:

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* 21. Responsibilities:

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* 22. How long did you work here?

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* 23. Reason for leaving?

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* 24. Supervisor's contact info:

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* 25. May we contact this employer?

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* 26. Prior Work Experience-
List Employer's info:

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* 27. Job Title:

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* 28. Responsibilities:

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* 29. How long did you work here?

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* 30. Reason for leaving?

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* 31. Supervisor's contact info:

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* 32. May we contact this employer?

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* 33. More prior work experience-
Email resumes and other info to Jobs@lostpizza.com
Please list any other jobs that relate to this one:

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* 34. E-Signature-

Disclaimer- By typing my name here, I hereby certify that the above information, to the best of my knowledge, is correct. I understand that falsification of this information may prevent me from being hired or may lead to my dismissal if hired. I also provide consent for employers to be contacted regarding my work records.

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