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Employment Application

STORE LOCATION (Please select the location where you are interested in applying.)

PERSONAL INFORMATION

Name:

Address:

Employment Desired

Are you currently employed? Yes No
If so, may we call your current employer for a reference? Yes No
Were you previously employed by Little Caesars? Yes No
Where: When:
Do you have any relatives working for Little Caesars? Yes No
Which Location?
List names/relationships
Indicate the shifts you are available to work by marking an "X" in the boxes below
  Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Lunch (OP-4)
Dinner (4-CL)

GENERAL INFORMATION

Are you at least 16 years of age? Yes No

If No, list age

Are you available to work? Full Time Part Time

Are you willing to work flexible hours to include weekends, holiday, and overtime, when necessary? Yes No

If hired, can you provide proof of U.S. Citizenship or authorization to legally work in the U.S.?

Have you ever been convicted of a felony, pled guilty or no contest to a felony, or are you currently on probation or deferred adjudication for a felony? (Please exclude sealed, expunged, legally eradicated or misdemearnor convictions for which probation was successfully completed). A conviction does not mean you will not be offered a job. The offense for which you were convicted and the circumstances and date of the conviction will be considered as important factors in the hiring decision.
Yes No

If Yes, explain:

Are you willing and able to take a drug test if asked or submit to a background check (employment is contingent on a successful drug screen and background check)?
Yes No

EMPLOYMENT INFORMATION / HISTORY

List your past employers, and assignments for the past three employers, starting with the most recent. Include military service, if applicable. You may attach a resume, but it may NOT take the place of the information on this application.

EMPLOYER 1:
Employer
Address
Job Title Supervisor/Title
Reason for Leaving:

May we contact? Yes No

Telephone#
Dates Employed: From: To:
Starting Base Salary Ending Base Salary
Nature of work performed and job responsibilities
EMPLOYER 2:
Employer
Address
Job Title Supervisor/Title
Reason for Leaving:

May we contact? Yes No

Telephone#
Dates Employed: From: To:
Starting Base Salary Ending Base Salary
Nature of work performed and job responsibilities
EMPLOYER 3:
Employer
Address
Job Title Supervisor/Title
Reason for Leaving:

May we contact? Yes No

Telephone#
Dates Employed: From: To:
Starting Base Salary Ending Base Salary
Nature of work performed and job responsibilities

EDUCATION

High School College Other
School
City
State
Years Completed
Degree

Acknowledgement

PLEASE READ THE FOLLOWING CAREFULLY AND SIGN BELOW

If you have any questions regarding the following statements, please ask for assistance.

I am able to perform the essential duties of the job for which I am applying:
Without special accommodations
With reasonable accommodations - Please explain

I hereby authorize the Company to contact any of my previous employers as well as any reference source to verify the facts and information that I have furnished regarding my qualifications and my character to obtain information from other private companies through: drug and background checks; educational institutions concerning my educational record; conduct and skills; military authority; and credit reporting agencies concerning my credit history. I authorize any person(s) having knowledge to provide such information to the Company, and release from liablilty and agree to hold harmless of all claims, demands or liablilities any person that furnishes such information in good faith as allowed by law.

Initial

Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by the Company, I am entitled to copies of any such public records obtained by the Company unless I mark the check box to waive. If I am not hired as a result of such information, I am entitled to a copy of any such records, even though I have checked the box below.
Waive
Initial

I understand this is only an application for employment and neither an offer nor contract of employment. No part of this application shall be construed as an offer of employment or an employment contract. I further understand that nothing contained in this application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and Little Caesars.

Initial

I understand that Little Caesar is an At-Will employer and that my employment may be terminated at any time with or without prior notice, at the option of either myself or the Company and that no promises are binding on the Company unless made in writing and signed by me and the Company'es designated representative.

Initial

By checking this box, I declare that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct. I further declare that I, the undersigned applicant, have personally completed this application. I understand that any false statements or omissions on this application or any document used to secure employment shall be grounds for rejection of this application or immediate discharge if I am employed, regardless of the time lapse prior to discovery.

Initial