Chick-fil-A 46th St. & 6th Ave. Location
Application for Employment
Please tell us about yourself
First Name *
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Last Name *
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Name Used *
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Date *
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Present Address *
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City *
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State *
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Zip *
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Telephone *
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Email Address *
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Do you have a reliable means of transportation to work? *
What wage rate are you expecting? *
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Are you younger than 18 years old? *
If Yes, do you have a work permit?
If hired, can you provide verification of your legal right to work in the U.S.? *
(Proof of eligibility is required upon employment)
Availability
Please list days and times available to work below. *
Monday-Saturday, we have employees in the restaurant daily from 5AM-2AM.
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Minimum weekly number of hours needed to work. *
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Maximum weekly number of hours needed to work. *
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Have you ever worked for a Chick-fil-A, Inc. or a Chick-fil-A Franchisee? *
If YES, which Unit?
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Previous Employment History
Please list your three most recent jobs (including babysitting, lawn care or volunteer work):
Name & Address of Employer
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Employed from:
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Employed to:
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Phone Number
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Supervisor
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Reason for leaving
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Name & Address of Employer
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Employed from:
MM
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DD
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YYYY
Employed to:
MM
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DD
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YYYY
Phone Number
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Supervisor
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Reason for leaving
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Name & Address of Employer
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Employed from:
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DD
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YYYY
Employed to:
MM
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DD
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YYYY
Phone Number
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Supervisor
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Reason for leaving
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Relevant Skills
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Education
High School (Last attended) *
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Location *
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Did you graduate?
College & Vocational Schools
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Did you graduate?
If YES, Degree & Major
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Grade point average
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Personal Background
Please list job-related awards and/or leadership positions held (work or school)
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Military Service
MIlitary Service
Branch
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Rank
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Start Date
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End Date
MM
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YYYY
Relevant Skills
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Screening Questions
Why do you want to work for Chick-fil-A? *
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Tell us about a time you went above and beyond to help someone. *
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What three accomplishments are most proud of and why? *
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What are your areas of improvement? *
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Tell us about a difficult decision you've made recently. What helped you make that decision? *
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How did you hear about this job? *
Please read the following statements carefully
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.

I have read the above statements *
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