Application Form To give us some insight into your background and experience, please complete this form and return it to us if you are interested in obtaining more information about employment with Milano's Pizza. Please note it is mandatory to complete all information marked with an asterix within this application. Given Names   Last Name   Date of Birth   Home Address   County   Postcode   Contact Phone No   Email   Where did you hear about the job?   Box Topper Employment Agency Internet Referred by current team member Store banner Worked for Milano's previously Walk-in Newspaper Ad A good attendance record is important at Milano's. Is there anything that would force you to be consistently late?   No Position & Availability All employees are required to work at least one weekend night Position Applied for   Date you can start   Are you currently employed?   Yes No   What is the maximum hours you can work?   Mon Tue Wed Thu Fri Sat Sun From To   Do you plan to keep working there if you work for Milano's?   Yes No Employment Record Please list all previous employers, starting with the most recent. If you have previously worked for Domino's, please write the store location. Name of current employer   Job Title   Address   Starting Date   Name and title of supervisor   May we contact the supervisor   Yes No Phone No   Reason for leaving   Car Details All personnel involved in product delivery for Milano's Pizza must have their licenses and Insurance reviewed before beginning employment and every 120 days thereafter. In addition, all team members must meet the following requirements: No team member will be allowed to drive any vehicle for Milano's Pizza without a valid driver's license from the state of their primary residence. Licenses must be in good standing (i.e. not suspended, revoked or restricted) Individuals must show proof of and maintain comprehensive third party car insurance. A letter from your insurance company that states your car is covered by your private policy while delivering pizzas, along with a copy of your policy is ample proof. All vehicles used for delivery or other company business must pass a safety inspection. No one may be hired into a position which requires driving unless their driving record meets Milano's Standards. Country License was issued   Date from which you held a valid license   License Number   License expiry date   Vehicle Make   Model   Year   Registration Number   Do you have any charges pending against you for any traffic violation which could see your license being suspended, revoked or restricted?     No Declaration I certify the facts contained in this application are true and complete. I understand that, if employed, false statements or omissions on this application are grounds for dismissal. I acknowledge that I have read and agree to comply with every aspect or the job description and the uniform standards listed on this application form should I be employed. I give my authorization to verify all information provided in this application.