Team Member Application Form

Application

Please complete the entire application.
Applicant Information
Employer: Piikup

City: Oakland

Telephone: 510-560-2463

Email: Operations@piikup.com

It is the policy of Piikup 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.
Full Name

First NameMiddle NameLast Name
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Mobile Phone Number
Format: (000) 000-0000.
I.D. or CA Driver License Number (State/#)
Date Of Birth
Emergency Contact
Name

First NameLast Name
Relationship to you
Phone Number
Format: (000) 000-0000.
Please answer questions below
List the computer or mobile apps that you use on a weekly basis
What days are you Available?
What times are you Available?
How did you hear about Piikup ?
Do you have friends or relatives that work for Piikup ?
If so who?
Have you applied to our Piikup before ?
If yes, when?
Which postion(s) are you applying to?
Are you at least 25 yrs of age ?
If hired, are you able to submit proof that you are legally eligible for employment in the United States?
Yes or No
Applicant Employment History
Have you ever been written up or fired?

Other
If yes, tell us more about what happened
Current or last Employer Name
Last employers Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Duties
Reason for Leaving
Date started

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date left

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
References

List a non-relative who would be willing to provide a reference for you.
Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Relationship
We collect information about our team to make sure we are connecting them to the resources that they might need and to ensure we meet the reporting responsibilities of our funders.
Please select all that apply
What issues, causes or world issues are important to you?
What is your cultural identity. (Please self identify)
I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

I authorized The Delivery Chef to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If an employment relationship is created I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Owner, the employment relationship will be "at will". In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of The Delivery Chef, except in a specific written contract of employment signed on behalf of the organization by its Owner, has the power to alter or vary the voluntary nature of the employment relationship.

I have carefully read the above certification and I understand and agree to its terms.
Type Name

First NameLast Name
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