Last Name First Middle Date of Application

Street/P.O. Box Apt. # City

State Zip Home Phone Cell Phone

Please list any other names you have used

Emergency Contact’s Name Home Phone Work Phone Cell Phone Street/P.O. Box Apt. # City State Zip

APPLICATION FOR PART TIME

CREW EMPLOYMENT - FRANCHISE OWNED STORES

Incomplete applications

may not be considered

PERSONAL

1. Are you at least 18 years old? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No If no, please list birth date._ 2. Are you a United States citizen or legally authorized to work in the United States? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

(If hired, you must submit verification of your legal right to work in the United States) 3. Have you ever been employed by Little Caesars? Corporate or, Franchise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No If so, when? City State What position? Who was your immediate supervisor/owner? Why did you leave?_ 4. What prompted you to apply for work here? Company Image Internet Friend Newspaper Employee Referral_ Other 5. Is any member of your family (spouse, parent, sibling, in-law, etc) employed in the restaurant industry? . . . . . . . . . . . . . Yes No If yes, please explain:_ EDUCATION

6. What hours or shifts are you available for work? Please note both hours available and hours unavailable to work in the table below.

*Do not explain reasons for hours you are not available. Availability Monday Tuesday Wednesday Thursday Friday Saturday Sunday Available

*Not Available

7. How soon after accepting an offer would you be able to start working?_ 8. Do you have a reliable source of transportation that will get you to work on a timely basis? . . . . . . . . . . . . . . . . . . . . . Yes No Name and Location of School Circle Highest Year

Completed

Major and

Fields of Study

Degree(s)

Diploma

High School 9 10 11 12

Technical School

College 1 2 3 4

Other

AVAILABILITY FOR WORK

Little Caesars Pizza Franchise Application – April 2021 – NCV CONFIDENTIAL 4.21 [LC307] BL#685646 ESSENTIAL JOB FUNCTIONS AND MOTIONS

• Must be able to see sufficiently to maintain safety and

• • • determine Must Must Must be have be able able product mobility to to count, stand quality, to get for separate long to service multiple periods and and stations weigh of cleanliness. time. all within types the restaurant.

• of Must food be products able to withstand and inventory 90º+ items. heat in the summer

• and Must below be able freezing to “Shakerboard” in the winter. by working outside holding a sign

• • and Must Must shaking be be able able it. to to work follow with directions 650º oven and temperatures. communicate (i.e. speaking, reading, hearing, writing) with customers, crew and management.

• The ability to process and complete customer orders, including counting money and processing credit card transactions properly. The ability to do the following:

• • • Lift Lift Bending one one or or of both both one or arms arms both over from arms head your to your sides up to shoulders up 100%to 100%. up . to 100%.

• B ending of the back up to a minimum of 90º to lift objects from

• • • Lifting, the Twisting Squat floor. or pushing of crouch the back and to lift pulling up items to 90º up from left to 55 floor and pounds. level. right. 9. Little Caesars employees are required to work all positions within the restaurant. This requires different essential job functions to be completed. Performing these positions enables us to provide quality products to our customers within a short period of time. EMPLOYER/APPLICANT STATEMENT

Little Caesars Pizza Franchise Application – April 2021 – NCV I represent that the above information, and any other information I may be required to provide, is complete and accurate and any misstatement or omission may result in rejection of my application or termination of employment. I authorize Little Caesars Pizza to investigate my references and communicate with my former employers concerning my employment unless specifically stated otherwise in this application. I authorize all individuals, schools, and employers named, and all financial institutions, law enforcement agencies, and all persons except as specifically limited on this application to provide information requested about me, and I promise I will not bring any legal claims or actions against my current or former employers due to their responses to any job reference request.

Completion of the Employment Application is a preliminary step to employment. It does not authorize Little Caesars Pizza to offer me employment or for me to accept an offer of employment. I agree that if I am hired, my employment may be terminated at any time for any reason or no reason at all or without notice by me or the franchisee of Little Caesars Pizza. I agree that only the franchisee of Little Caesars Pizza has authority to enter into an employment arrangement other than “at-will” and it must be in writing and signed by the franchisee and me.

If I am hired, in consideration for my employment, I agree to comply with the policies, procedures, guidelines and standards of conduct of the franchisee of Little Caesars Pizza. I agree to keep confidential all proprietary information I learn about Little Caesars Pizza by virtue of my employment with a franchisee of Little Caesars Pizza and I shall not disclose it or use it for my own personal gain or for the benefit of a third party. This application was designed to comply with Title VII of the Civil Rights Act, The Age Discrimination in Employment Act, The Americans with Disabilities Act, as well as other applicable federal or state Fair Employment Practice Laws. Therefore, no question answered is or will be used to discriminate on the basis of race, color, creed, national origin, religion, age, sex, sexual orientation, gender identity or expression, uniformed service, disability, pregnancy, veteran status or any other characteristic protected by federal or local laws. FOR ARIZONA APPLICANTS: The smoke-free Arizona act, a.R.S. § 36-601.01, prohibits smoking in places of employment and within 20 feet of all entrances, open windows, or ventilation systems. FOR CALIFORNIA APPLICANTS: I recognize that I may waive my right to receive a copy of any public record obtained by the company when conducting a background investigation of me per the requirements of California’s investigative consumer reporting agencies act (California civil code § 1786, et seq.). I may waive my right by checking this box:

I do not wish to receive a copy of any public records obtained by the company about me through non-icra sources.

FOR MARYLAND APPLICANTS: Under Maryland law, an employer may not require or demand, as a condition of employment, prospective employment or continued employment, that an individual sub- mit to or take a lie detector or similar test. Employer who violates this law is guilty of a misdemeanor and subject to a fine not exceeding $100.

FOR MASSACHUSETTS APPLICANTS: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. FOR MONTANA APPLICANTS: The employment relationship is governed by the wrongful discharge from employment act. Mont. Code ann. § 39-2-901.

FOR RHODE ISLAND APPLICANTS: If you provide false information about your ability to perform the essential functions of the job, with or without accommodations, you may be barred from filing a claim under the provisions of the workers’ compensation act of the state of Rhode Island. Signature:_ Date: This application for employment is with a franchisee of Little Caesar Enterprises, Inc. as this location is independently owned and operated. As an independent owner, and pursuant to a contractual relationship with Little Caesar Enterprises, Inc., the franchisee is solely responsible for all employment practices and decisions. To the extent that any law dictates employment practices or requirements, it is the franchisee’s obligation under the franchise agreement to obey all applicable laws. Applications are effective for 60 days, after which you must reapply. This period may be extended if you are interviewed for a management position during the 60 day period. 10. Can you perform the essential functions of the job as set forth above with or without a reasonable accomodation? . . . Yes No CONFIDENTIAL 4.21 [LC307] BL#685646

WORK HISTORY

(No section should be left blank.)

Current or Most Recent

Employer Previous Employer Previous Employer

EMPLOYER

ADDRESS / LOCATION

(Include City, State, & Zip)

DATES EMPLOYED from: to: from: to: from: to:

POSITION(S) HELD

SUPERVISOR’S NAME

PHONE NUMBER

MAY WE CONTACT

CURRENT EMPLOYER? Yes No Yes No Yes No

RESPONSIBILITIES

REASON FOR LEAVING

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