Join the Souzza Team!

Store Application
 
PLEASE PRINT THE FOLLOWING APPLICATION AND RETURN IT TO:
 
SOUZZA
3315 Lincoln Way E
Massillon OH 44646 
 
EMPLOYMENT APPLICATION
 
It is the policy of Souzza LLC to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status.
 
 
APPLICANT INFORMATION
 
Name
__________________________________________________________
 
Address
__________________________________________________________
 
City State Zip
___________________ ____________________ __________________
 
Phone
__________________________________________________________
 
SSN
___________________-____________________-__________________
 
Driver’s License / State Number
___________________________________________________________
 
 
EMERGENCY CONTACT
 
Who should be contacted if you are involved in an emergency?
 
Name
__________________________________________________________
 
Phone
__________________________________________________________
 
Relationship
__________________________________________________________
 
Address
__________________________________________________________
 
City State Zip
___________________ ____________________ __________________
 
 
OTHER RELEVANT INFORMATION
 
What position are you applying for?
__________________________________________________________
 
Salary Desired?
$___________________________ per___________________________
 
Who referred you to our team?
__________________________________________________________
 
Have you applied to our company previously?   Y  or  N
If yes when?
mo.__________________________ year__________________________
 
Are you at least 18 years of age or older?   Y  or  N
 
Are you willing to work any shift, including nights and weekends?   Y  or  N
If no, please state limitations.
__________________________________________________________
__________________________________________________________
 
If you are offered employment, when would you be able to begin work?
mo.________________ day_________________ year_______________
 
Are you legally eligible for employment in the United States?   Y  or  N
 
Are you able to perform the essential functions of the job position with or without reasonable accommodations?   Y  or  N
What reasonable accommodations would you require?
__________________________________________________________
 
Have you ever been convicted of any crime other than traffic violations?   Y  or  N
If yes, please describe using the following lines. dates, offense, charge etc.
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
 
THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT.
APPLICANT EMPLOYMENT HISTORY
 
 
Most Recent Employer
__________________________________________________________
 
Supervisor’s Name
__________________________________________________________
 
City State Zip
___________________ ____________________ __________________
 
Job Duties
__________________________________________________________
 
Reason for Leaving
__________________________________________________________
 
Dates of Employment
mo.__________________________ year__________________________
to
mo.__________________________ year__________________________
 
 
 
Next Most Recent Employer
__________________________________________________________
 
Supervisor’s Name
__________________________________________________________
 
City State Zip
___________________ ____________________ __________________
 
Job Duties
__________________________________________________________
 
Reason for Leaving
__________________________________________________________
 
Dates of Employment
mo.__________________________ year__________________________
to
mo.__________________________ year__________________________
 
 
EDUCATION AND TRAINING
 
High-school
__________________________________________________________
 
Did you receive a diploma or GED?   Y  or  N
 
City State
_____________________________ _____________________________
 
Other Training (graduate, technical, vocational)
__________________________________________________________
 
Awards, Honors & Special Achievements
__________________________________________________________
 
Please provide any information that you believe should be considered. skills, past experience etc.
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
 
REFERENCES
 
Name
__________________________________________________________
 
Phone
__________________________________________________________
 
Relationship
__________________________________________________________
 
 
Name
__________________________________________________________
 
Phone
__________________________________________________________