Outgoing, reliable, professioal

Date recʼd

At store #

Recʼd by

PERSONAL INFORMATION

Current Address City/State/Zip

Telephone # Other # Email

Other Names (so that we may verify your employment history) EMPLOYMENT HISTORY

EDUCATION & SKILLS

YES NO

YES NO YES NO

May we contact your current employer? YES NO

YES NO

High School: Name City State

Circle highest grade completed: 9 10 11 12 GED Are you still attending? College/Technical or Trade school/or other education/training (List all whether or not degree was obtained) Name Address Dates Major Minor Degree completed

Describe any abilities, experience, or aptitude that you believe would be helpful in your job Are you under 18 years of age? Have you ever worked for Charo Chicken before? Are you legally authorized to work in the US?

EEID

(If Hired)

M.I.

COMPANY NAME EMPLOYMENT DATES From To Salary per hour Address Phone#

Title Supervisorʼs Name

What kind of work did you do? Why did you leave?

COMPANY NAME EMPLOYMENT DATES From To Salary per hour Address Phone#

Title Supervisorʼs Name

What kind of work did you do? Why did you leave?

COMPANY NAME EMPLOYMENT DATES From To Salary per hour Address Phone#

Title Supervisorʼs Name

What kind of work did you do? Why did you leave?

Last Name

First Name

Email completed application to: ad0a72@r.postjobfree.com JOB INTEREST

How many hours per week would you like to work?

How did you hear about Charo Chicken

AN EQUAL OPPORTUNITY EMPLOYER: We are an equal opportunity employer and do not discriminate based upon race, color, religion, sex, sexual orientation, pregnancy, marital status, national origin, citizenship, veteran status, ancestry, age (over 40), physical or mental disability, medical condition (cancer-related), gender identity or expression, genetic information including sickle cell or hemoglobin C trait, or any other consideration made unlawful by applicable federal, state, or local law. YOUR AVAILABILITY

How soon could you start working for Charo Chicken Shifts vary by store, starting as early as 9:30 a.m. and ending as late as 10:30 pm. Please confirm the shift schedule needed at your store. What is your availability?

EARLIEST TIME

LATEST TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY PLEASE READ CAREFULLY BEFORE SIGNING:

I read and understand the Position Description and can perform the essential functions with or without a reasonable accommodation. I answered every question on this application completely, truthfully and correctly. I understand that if I am hired and any of the information I provided is found to be untruthful, misstated, or purposely omitted, I could lose my job. I understand that this application is not an offer, promise, or contract of employment, either expressed or implied. My employment would be “at will” and could be terminated by either Charo Chicken or me at any time, with or without notice or cause. APPLICANT'S SIGNATURE (Void unless signed and dated) DATE TERMS OF HIRE

What position are you applying for? Manager Assistant Manager Shift Leader Cashier Driver Cook

Contact this candidate