Madison West

Locally Owned & Operated

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5003 University Ave.
Madison, WI 53705

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Employment Application


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Any offer of employment is conditioned upon completing form I-9 and providing the appropriate documents for identity and work authorization.


Work Availability

Shifts begin as early as 8am and end as late as 2am.



Please list two personal or professional references who have known you for more than one year.


Previous Employer 2


(Please read carefully, then sign and date below)
I certify that I have personally completed this application. I declare that the information provided in this employment application is true and complete and I understand that any false information or significant omissions may disqualify me from further consideration for employment and may be justification for my dismissal from employment if discovered at a later date. I agree to immediately notify Glass Nickel Pizza if I should be convicted of a crime while my job application is pending or during my employment, if hired.
I authorize Glass Nickel Pizza to make an investigation of all information contained in this employment application and I release from liability all companies and corporations supplying such information. I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or discharge.
I specifically authorize and direct my current and former employment-related information to Glass Nickel Pizza and do hereby release my current and former employers from liability for providing information to Glass Nickel Pizza.
Upon termination of my employment for whatever reason, I release Glass Nickel Pizza from all liability for supplying any information concerning my employment to any potential employer.
I authorize Glass Nickel Pizza, if applicable, to request a copy of my credit report, motor vehicle driving record, and any other investigative report deemed necessary through various third party sources. As required by law, upon request within a reasonable period of time, I will be notified as to the nature and scope of such investigations.
I hereby agree to submit to any drug test required of me, whether prior to my employment by Glass Nickel Pizza at any time thereafter. If requested, I will take a post-job offer physical examination and my employment, in the event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to my condition between the treatment provider and a company-designated physician.

I understand and agree that nothing contained in this application, or conveyed during any interview is intended to create an employment contract between Glass Nickel Pizza and me. In addition, I understand and agree that if you employ me, in consideration of my employment, my employment and compensation will be at-will, for no definite period of time, and my be terminated at any time, for any reason, or for no reason at all. I understand that only the company is authorized to change the employment-at-will status and such a change would be done in writing. I have read, understand, and agree to the above.
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Madison West