Rainbow Pizza Form

Full Name(required)

Phone Number(required)

Email Address(required)

Which Rainbow Pizza/Domino's location(s) did you work at?(required)

Dates of Employment? (For example, June 2016-May 2017)(required)

What were you paid when you were driving? (For example, $5.25/hr)(required)

What were you paid per delivery? (For example, $1.50 per delivery) (required)

Who were your manager(s)(required)

On average, how many miles did you drive per day while delivering pizzas?(required)

How many deliveries did you make per hour? (For example, 3 delivers per hour) (required)

On average, how many miles did you drive per delivery (including the trip back to the store?)(required)

Do you have any documents showing mileage estimates and costs? (For example, tax documents, photos of your odometer, receipts, etc.)(required)

Did you ever work off the clock? If so, please explain. (required)

Did you ever have any issues with not being paid for all of the hours you worked? If so, please explain.(required)

Are there any additional drivers who we may contact to be your witnesses or join your claim? If so, what are their names and contact information?