date
PERSONAL INFO.
last name
first name
date of birth
permanent address
city
state
zip
summer address
city
state
zip
school address (if applicable)
city
state
zip
home phone
summer phone
mobile
email address
AVAILABILITY
position desired
salary/wages
full time (30-40 hr/wk)
or part time (15-25 hr/wk)
desired shift/s: breakfast/lunch
dinner
late night
starting dates: date you can begin working weekends
date you can begin working full time
ending dates: date you can work through full time
date you can work through weekends
PERSONNEL
have you ever been convicted of a felony? yes
no
are you a US citizen? yes
no
can you legally work in the US?
are you prepared to provide proof of elegibiltiy to work in the US?
are you currently employed? yes
no
if yes, may we contact your employer
have you ever applied with this company before? yes
no
have you ever been hired by this company before? yes
no
do you have transportation to and from work? yes
no
emergency contact:
name
relationship
phone 1
phone 2
EDUCATION
high school
number of years completed
continued education: college/trade school/ grad school
1.
number of years completed
2.
number of years completed
3.
number of years completed
RECENT EMPLOYMENT
1. company name
period of employment
position
salary/wages
reason for leaving
2. company name
period of employment
position
salary/wages
reason for leaving
PERSONAL REFERENCES
1. name
relationship
address
phone
2. name
relationship
address
phone
why do you want to work for the chicken or the egg?
what can we do for you?
why should we hire you?
what can you do for us?
Electronic Signature: I certify that all the information subitted by
me on this online application is true and complete and I understand
that if any false information is discovered my application may be rejected
and if I am employed, my employement may be termiateed at any time.
In consideration of emmplyment, I agree to conform to the Chicken or
the Egg's rules and regulations and I agree that my employment and
compensation may be terminated with or without cause and with or
without notice at either my or the company's discretion.
type in full name
date