Thank you for your interest in employment with Palermo Villa, Inc. To give us a clear understanding of your background and work history, we ask that you fill in all information requested. This greatly enables us to fill positions with the most qualified candidates. If you have a resume, please email it to careers@palermospizza.com. We still require that you complete an application for employment. Applications are considered active for 90 days. If you need any assistance in the completion of this form or in our application process, please ask and we will be glad to assist you. We comply with U.S. Immigration laws and do not employ persons who are unauthorized to work. If hired, the company will require each person to produce proper identity and employment authorization documentation.

Last Name First Name Middle Name
Social Security Number
Address City State Zip
Previous address (if at residence listed above for less than 5 years)
Address City State Zip
Telephone Number(s) May we contact you at work?
Home: Work:
Are you 18 or older?
When is the best time to contact you?
Position you are applying for:
Is this in response to an advertised position?
Are you currently employed?
Work Status Preference:
If offered employment, when would you be available to start?
Open the calendar popup.
Rate/Range of pay desired:
Have you ever been employed with Palermo Villa?
If yes, position(s) held and approximate dates worked:
Have you ever applied at Palermo Villa before?
If yes, please give date(s) and position(s) applied for.
Do you have any relative(s) currently working for Palermo Villa?
If yes, what are their name(s) & relationship(s) to you?
If position requires, are you willing to travel?
Have you ever worked under a different name? Please list:
Do you prefer:
May you lawfully work in the United States?
Are there any limitations on your availability for work or overtime?
If yes, please describe:
Have you ever been convicted of a crime that has not been removed or sealed from your record?
If yes, state date, place, and nature of conviction.*
* Note: A criminal record does not constitute an automatic bar to employment. It will be considered only if it substantially relates to the job for which you are applying.
Have you ever been discharged or asked to resign from any position?
If yes, please explain:

Employment Experience
Start with present or last job and leave no gaps.
Employer Dates Employed Work Performed
From To
Address
Open the calendar popup.
Open the calendar popup.
Hourly Rate/Salary
Telephone Number(s)
Starting
(Ex: 25000)
Final
(Ex: 30000)
Starting/Present Job Title Bonus (Ex: 5000)
Supervisor May we contact?
Reason for leaving

Employer Dates Employed Work Performed
From To
Address
Open the calendar popup.
Open the calendar popup.
Hourly Rate/Salary
Telephone Number(s)
Starting
(Ex: 25000)
Final
(Ex: 30000)
Starting/Present Job Title Bonus (Ex: 5000)
Supervisor May we contact?
Reason for leaving

Employer Dates Employed Work Performed
From To
Address
Open the calendar popup.
Open the calendar popup.
Hourly Rate/Salary
Telephone Number(s)
Starting
(Ex: 25000)
Final
(Ex: 30000)
Starting/Present Job Title Bonus (Ex: 5000)
Supervisor May we contact?
Reason for leaving

Position Specific Qualifications / Skills / Certifications etc.
Please list the job-related qualifications, skills, certifications, training, experiences, etc. you feel qualify you for the position with our company for which you are applying.
Education

Please select the highest grade completed. GED Post High School
Name of last school attended:
 Location:
Most current degree achieved:
 Cumulative GPA:
 Where obtained:

Applicant: Please read and initial before submitting this application

Thank you for your interest in employment with Palermo Villa, Inc. We comply with all federal, state, and/or local laws that prohibit unlawful discrimination in employment, including those based on race, religion, color, age, sex, national origin, disability, marital status, veteran status or other legally protected characteristic.

If you are hired, you will be required to present evidence of your legal right to work in the United States no later than three (3) days after commencement of your employment.

  • I certify that all statements and information contained in this application were made by me and are true, correct and complete to the best of my knowledge and belief. The correctness of all statements made herein may be investigated. I understand that any misstatement or omission of information shall constitute grounds for immediate dismissal or rejection of my application.
  • I authorize Palermo Villa to investigate my responses on this application and to contact all former employers or any individuals familiar with my employment, educational background and me unless so specified otherwise within this application form, including educational institutions. Such investigation is for purposes of verifying information I have provided or for obtaining any information — whether favorable or unfavorable — about my employment, education or me. I hereby authorize any and all persons and organizations having information pertaining to me and my past and current employment and education to disclose such information to Palermo Villa, Inc. in connection with its consideration of this application of employment (and any resulting employment, if applicable) and I voluntarily and knowingly fully release and hold harmless Palermo Villa, Inc, and any person or organization that provides information pertaining to me and/or employment, as conditioned by law.
  • If employed by this organization (Palermo Villa, Inc.), I agree:
    • To assign to the organization all inventions relating to the business of the organization or resulting from tasks assigned to me by the organization, which inventions are made by me, alone or jointly with others during such employment or within one year following termination thereof.
    • The confidential information and knowledge I acquire in such employment is to be kept confidential and to be divulged only when authorized by the organization.
    • All outstanding expenses owed the organization may be deducted from my paycheck and/or from any other amounts owed to me by the organization.
    • The organization may inspect all personal property brought on to or removed from organization premises at any time without notice.
    • Employment and compensation can be terminated without cause and without notice, at any time, at the option of the organization or the employee. I understand that unless such agreement/contract has been executed in writing to me by the President, my employment with Palermo Villa is “at-will” and I in no way bind Palermo Villa Inc. to a contractual agreement regarding permanency of employment.
  • I understand that a job offer will be subject to the following:
    • A physical examination and/or drug screening, if required for the position. (Note: If this is a job requirement, you will be notified of this requirement following an offer of employment. Such requirement would have to be successfully completed as a condition of employment.)
    • Verification of my social security number by the Company using the Social Security Administration’s verification system to accurately provide information for tax reporting and other withholding purposes. I understand that a start date may not be determined until such verification is completed.
    • A Proprietary and Confidentiality Agreement may be required. If such an agreement is required, you will be notified.
  • Regardless of whether or not I become employed by Palermo Villa Inc., I recognize that this form, Palermo Villa Inc.’s application process, and any offer of employment should not be considered as a contract of employment. I understand that no person other than the President has the authority to offer any agreement regarding employment or an employment contract;

Initials