(fine)? Answering yes won’t automatically disqualify you. _____________ If yes, please explain:__________________________________________________________________ _____________________________________________________________________________________ EDUCATION HISTORY No. Years Graduated Degree/Major G.P.A. Attended Yes/No Name High City State School Name College City State Name Graduate School City State Name Other City State REFERENCES Name Company & Title Years Acquainted 1 Address Phone Name Company & Title Years Acquainted 2 Address Phone I hereby certify that this application and any other materials and/or documents provided in this application process contain no willful misrepresentation and that the information given is true and complete to the best of my knowledge. I am aware that should investigation at any time disclose any such misrepresentation or falsification, my application will be rejected, my name may be removed from consideration, or if employed, I may be discharged from my employment. I authorize my current or former employers and all schools or educational and technical institutions which I have attended to provide The Pasta Shoppe representatives any information regarding my current or former employment. I hereby release any such current or former employers or institutions from any and all liability resulting from the release of such information. My authorization and release from liability are voluntary acts. Signature ____________________________________________ Date: __________________________
(fine)? Answering yes won’t automatically disqualify you. _____________ If yes, please explain:__________________________________________________________________ _____________________________________________________________________________________ EDUCATION HISTORY Degree/Major G.P.A. No. Years Attended Graduated Yes/No High School Name City State College Name City State Graduate School Name City State Other Name City State REFERENCES 1 Name Company & Title Years Acquainted Address Phone 2 Name Company & Title Years Acquainted Address Phone I hereby certify that this application and any other materials and/or documents provided in this application process contain no willful misrepresentation and that the information given is true and complete to the best of my knowledge. I am aware that should investigation at any time disclose any such misrepresentation or falsification, my application will be rejected, my name may be removed from consideration, or if employed, I may be discharged from my employment. I authorize my current or former employers and all schools or educational and technical institutions which I have attended to provide The Pasta Shoppe representatives any information regarding my current or former employment. I hereby release any such current or former employers or institutions from any and all liability resulting from the release of such information. My authorization and release from liability are voluntary acts. Signature ____________________________________________ Date: __________________________
Application_-_2013.85154640.docx