Fillable Printable Chicken Express Application Form
Fillable Printable Chicken Express Application Form
Chicken Express Application Form
APPLICATION FOR EMPLOYMENT
(We are an equal opportunity employer)
Application Date: __________________________
PERSONAL INFORMATION: (please print clearly)
Last Name _____________________________________________________
First Name ______________________Middle _______________________
Ph. Home ________________________Cell ________________________
Home Address _________________________________________________
City ________________________________State ______Zip____________
If you are under 18 years of age please state your birthday
Month _______________Day ______Year _____________
(No one under 18 may be hired)
Are you employed now? o yes o no
If yes by whom? _______________________________________________
Business Ph. for contact ________________________________________
May we contact you at work? o yes o no
IN CASE OF EMERGENCY NOTIFY:
Name _________________________________________________________
Relationship ___________________________________________________
Phone _________________________________________________________
EMPLOYMENT DESIRED:
Position Applying for ___________________________________________
Pay Expected __________________________________________________
Type of Position Desired ________________________________________
o Part Time o Full Time o Seasonal o Temporary
Will you work overtime if asked? o yes o no
Date you can start ______________________________________________
Are you willing to travel? o yes o no
Are you willing to relocate? o yes o no
Days and hours available:
MonTuesWedThursFriSatSun
From
To
PERSONAL INFORMATION: (please print clearly)
LEGAL
Are you legally able to be employed in this country?
o yes o no (if hired, verification will be required by law)
Did any company ever discharge you? o yes o no
If yes, give name of company(ies) ________________________________
Reason for discharge ___________________________________________
Have you ever been convicted of a crime other than a minor
traffic violation? o yes o no
If yes, please explain offense and final disposition: ________________
_______________________________________________________________
_______________________________________________________________
U.S. MILITARY SERVICE:
Branch of Service ______________________________________________
Rank Attained _________________________________________________
Technical Specialization ________________________________________
Type of Discharge ______________________________________________
Have you ever applied or been employed by this Chicken Express
or any other location(s)? o yes o no
Location ______________________________________________________
Date of employment ____________________________________________
Position Held __________________________________________________
Supervisor Name _______________________________________________
Reason for Leaving _____________________________________________
_______________________________________________________________
_______________________________________________________________
Name & Location of School Course of Study No. of yrs. attended Did you graduate Type of degree
High School
College
Business/Trade/Technical
Other special training or skills (languages, machine operations, etc.)
_______________________________________________________________________________________________________________________________________
The existence of a criminal record will
not automatically disqualify you from
the job for which you are applying.
EMPLOYMENT
(please begin with present or most recent employer)
Company Name ________________________________________________
Supervisor _____________________________________________________
Address _______________________________________________________
Phone No _____________________________________________________
Hourly Pay/Salary: Start _____________Last _______________
Employed - Month and Year
From ___________________________To____________________________
Job Title & Description __________________________________________
_______________________________________________________________
Reason for Leaving _____________________________________________
_______________________________________________________________
Company Name ________________________________________________
Supervisor _____________________________________________________
Address _______________________________________________________
Phone No _____________________________________________________
Hourly Pay/Salary: Start _____________Last _______________
Employed - Month and Year
From ___________________________To____________________________
Job Title & Description __________________________________________
_______________________________________________________________
Reason for Leaving _____________________________________________
_______________________________________________________________
Company Name ________________________________________________
Supervisor _____________________________________________________
Address _______________________________________________________
Phone No _____________________________________________________
Hourly Pay/Salary: Start _____________Last _______________
Employed - Month and Year
From ___________________________To____________________________
Job Title & Description __________________________________________
_______________________________________________________________
Reason for Leaving _____________________________________________
_______________________________________________________________
Company Name ________________________________________________
Supervisor _____________________________________________________
Address _______________________________________________________
Phone No _____________________________________________________
Hourly Pay/Salary: Start _____________Last _______________
Employed - Month and Year
From ___________________________To____________________________
Job Title & Description __________________________________________
_______________________________________________________________
Reason for Leaving _____________________________________________
_______________________________________________________________
To all applicants: Chicken Express tries to maintain a Drug-Free workplace, thus
there are policies in force to help achieve this. All applicants are required to take
a drug test. There will be random testing during employment and failing a test will
result in immediate dismissal.
Initial___________
This is to inform all applicants that if you are hired, we will give a 14 day working
trial (which means 14 days worked per employee time card) to decide if the job is
agreeable to either employee or employer, being either may terminate employment
without further incident.
Initial ___________
I understand that receipt of this application by Chicken Express does not imply
employment and that this application and/or any other Chicken Express documents
are not contracts of employment. I also understand that if hired, I will be required to
abide by all rules and regulations of Chicken Express.
Initial ____________
“I certify that the facts in this application are true and complete to the best of my
knowledge and understand that, if employed, falsified statements on this application
shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the employers listed
above to give you any and all information concerning my previous employment and
any pertinent information they may have. I release all parties from all liability for any
damage that may result from furnishing this information to you.”
Initial ____________
I further agree that I do not have an employment contract and that my employment
can be terminated or modified with or without notice or cause at any time by the
company of me.
Initial ____________
Signature ____________________________________________________Date ___________
COMPANY USE ONLYDo not write below
Interviewer ____________________________________________________
Date __________________________________________________________
_______________________________________________________________
