Chick-fil-A Palmhurst
Application for Employment – TEAM MEMBER STANDARD (v. 1) Date:
PLEASE TELL US ABOUT YOURSELF
Name (print): First ___________________ Middle I. _________ Last ___________________ Name Used: __________________ DOB: _____________
Present Address ____________________________________________________________ City _______________________________ State _____ Zip ___________
Primary Telephone ___________________________________________ Cell/Other Telephone (if applicable) _______________________________________
Email Address __________________________________________________________________________________________________________________________
Do you have a reliable means of transportation to work? Yes No What wage rate are you expecting? ______________________________
Are you younger than 18 years old? Yes No If Yes, do you have a work permit? Yes No
If hired, can you provide verification of your legal right to work in the U.S.? Yes No (PROOF OF ELIGIBILITY IS REQUIRED UPON EMPLOYMENT)
Have you ever been convicted of a felony? Yes No
If so, please indicate the crime, date of conviction, nature of circumstances, state in which offense occurred, and disposition:
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Note: Please do not answer yes or provide any information about convictions that have been erased, expunged, sealed, pardoned, set aside, vacated, annulled or otherwise eradicated by a court.” A “yes” response will not necessarily disqualify an applicant from employment. Failure to answer this question accurately could cause denial of employment or termination of employment.
AVAILABILITY
Please list days and times available to work below.
Monday Tuesday Wednesday Thursday Friday Saturday
FROM
TO
- Seasonal All Year Limitations to Availability _____________________________________________________________________________
Minimum weekly number of hours needed to work ___________________ Maximum weekly number of hours able to work ______________________
PREVIOUS EMPLOYMENT HISTORY
Have you ever worked for a Chick-fil-A, Inc. or a Chick-fil-A Franchisee? Yes No If YES, which Unit? _____________________________________
PLEASE LIST YOUR THREE MOST RECENT JOBS (including babysitting, lawn care or volunteer work):
Name & Address of Employer _____________________________________________________________________________________________________________
Employed From To Phone # Supervisor Wage rate Reason for Leaving
_____________ _______________ _______________________ ___________________________ _____________ ___________________________
Name & Address of Employer _____________________________________________________________________________________________________________
Employed From To Phone # Supervisor Wage rate Reason for Leaving
_____________ _______________ _______________________ ___________________________ _____________ ___________________________
Name & Address of Employer _____________________________________________________________________________________________________________
Employed From To Phone # Supervisor Wage rate Reason for Leaving
_____________ _______________ _______________________ ___________________________ _____________ ___________________________
Relevant skills:
______________________________________________________________________________________________________________________________________
Application for Employment (continued)
EDUCATION
High School (Last attended) Location Did You Graduate? Yes No
___________________________________________ __________________________________________________________________________________________
College & Vocational Schools Location Did You Graduate? Yes No If yes, Degree & Major Grade Pt. Avg.
__________________________________ ____________________________________________________ ____________________________ _______________
__________________________________ ____________________________________________________ ____________________________ _______________
PERSONAL BACKGROUND
Please list job-related awards and/or leadership positions held (work or school)
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
MILITARY SERVICE
- Yes No Branch ______________________ Rank_____________________________________ Start Date ______________ End Date ______________
Relevant skills
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
REFERENCES
Please provide four references (for example, current or past employers or supervisors; teachers; others familiar with your job qualifications).
Name Address Phone Relationship Years Known
__________________________________ __________________________________________ ____________________ ___________________ ___________
__________________________________ __________________________________________ ____________________ ___________________ ___________
__________________________________ __________________________________________ ____________________ ___________________ ___________
__________________________________ __________________________________________ ____________________ ___________________ ___________
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND SIGN
I understand that I am applying for employment at this particular Chick-fil-A® Restaurant location only and this location is operated by an independent franchisee
(the “Franchisee”). I further understand that completion of this application does not indicate that there are any positions currently open and does not obligate the
Franchisee to hire me.
I certify that all of the answers given in this application are true and complete to the best of my knowledge and that I have personally completed this application.
I understand that providing false or misleading information or omitting pertinent information in my application or a job interview shall be grounds for rejection of this application or for immediate discharge if I am employed.
I understand that if I am employed, my employment will be for no definite period of time. I understand that my employment may be terminated at-will with or without cause, and with or without notice, at the option of either the Franchisee or me.
I authorize all persons or businesses contacted by or on behalf of the Franchisee about me or my application to disclose any and all performance reviews, reports, and other documents and information related to my background, work history and qualifications, without giving me prior notice of such disclosure. I also authorize the persons named herein as references and others of whom the franchisee may inquire about my background to provide the Franchisee with any pertinent information they may have regarding me. By signing below, I fully release the Franchisee, my former employers and all other persons, and businesses from any and all claims, demands or liabilities arising out of or in any way related to such references or disclosures.
______________________________ ____________________________________________________________________________________
Date Applicant Signature
This Chick-fil-A Franchisee is an equal employment opportunity employer and considers all applicants without regard to race, color, religion, national origin, ancestry, citizenship, sex, pregnancy, age, physical or mental disability, genetic information, service in the uniformed services, and/or any other protected status, classification or factor, in accordance with the requirements of all federal, state and local laws. Applicants requiring reasonable accommodations to the application and/or interview process should notify the Franchisee.
Team Member Standard © 2006-2015 CFA Properties, Inc. Chick-fil-A® and Chick-fil-A Stylized® are registered trademarks of CFA Properties, Inc. [Rev. 3-15]
Chick-fil-A Palmhurst Additional Questions:
Why do you want to work at Chick-fil-A?
What skills will you bring to enhance the working environment at Chick-fil-A?
What do you do in your spare time?
Who is your hero and why?
Job Types: Full-time, Part-time
Pay: From $9.00 per hour
Expected hours: 20 – 40 per week
Benefits:
- Flexible schedule
- Paid training
Work Location: In person
