Register for Further Information You must fill in all fields marked with an asterisk (*) to Register.Name * Required First Last Phone Number * RequiredExtension (if applicable)May we call you at the above phone number? * RequiredYesNoEmail Address May we send you emails at the above address?YesNoHome Address Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Position with Pizza NovaPositionAddress of Pizza Nova Location worked atStart date (DD/MM/YYYY)End date (DD/MM/YYYY)CommentsBy ticking the confirm box below, I certify the following: * Required(a) I am NOT a person who is or what a director or officer of Pizza Nova or any of its franchisees; (b) I am NOT submitting this form on behalf of Pizza Nova or any of its franchisees or otherwise submitting this form as a representative or agent of Pizza Nova or any of its franchisees or affiliates or related organizations; (c) I am NOT a person who otherwise was not or is involved in the decision-making process for Pizza Nova, any of its franchisees, or its affiliated or related organizations; (d) I am NOT a person whose acts or omissions may expose or may have exposed Pizza Nova, any of its franchisees, or its affiliated or related organizations to potential liability in relation to the claims made in the statement of claim (namely, claims relating to alleged misclassification and unpaid wages). Yes, I confirm