Text Box:

On-line Application for Employment
Please Tell Us About Yourself

Your full name:  

Today's date:  Email address: 

Current Address:   City:  

State:   Zip:  Home Phone:  

Work Phone:  Mobile Phone:

In case of an emergency, we should notify: 

Address:   City:   State:   Zip: 

Home phone:   Work phone:  Mobile Phone:

Do you have a reliable means of transportation to work?  Yes  No

If you are younger than 18 years old, how old are you? 

What wage are you expecting?  

Social Security #: 

Are you legally eligible to work in the U.S.?  Yes  No
(Proof required upon employment)

Have you ever been convicted of a felony? Yes  No

If you are applying for a specific position please list it below. Any other comments?
Availability
MON TUE WED THU FRI SAT
FROM
TO

Summer:   School year:   All year: 

Minimum # of hours needed to work: 

Maximum # of hours needed to work: 

Previous Employment History
Have you ever worked for Chick-fil-A? Yes  No  

If YES, which store? 

Please list your 3 most recent jobs (including babysitting, lawn care, etc.). Be sure to provide (as many as you can) the following details for each:

  • Employed from/to
  • Name & Address of employer
  • Phone #
  • Supervisor
  • Earnings
  • Reason for leaving
Education
High School (last attended):   Location: 
Did you graduate? Yes  No

College/Vocational School:   Location: 
Did you graduate? Yes  No
If yes, Degree:   Major:   GPA: 

College/Vocational School:   Location: 
Did you graduate? Yes  No
If yes, Degree:   Major:   GPA: 
Personal Background
What are your interests and activities?


Please list awards and/or leadership positions held (work or school):
Military Service
Have you ever served in the military? Yes  No
Branch:   Rank: 
Start Date:   End Date: 

Please describe your duties:
Personal References
Please provide four references to whom you have been accountable in a work environment. Please include no more than two family members. Be sure to provide the following details for each:
  • Name
  • Address
  • Phone
  • Relation
  • Years known
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY

I understand that completion of this application does not indicate that there are any positions currently open and does not obligate the Chick-fil-A Operator 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 are subject to confirmation by Chick-fil-A.

Chick-fil-A may make such investigations and inquiries of my personal, employment, financial, and academic history, and other related matters as may be necessary in determining whether I can perform the essential functions of the position which I seek. I hereby release past employers, schools, and all persons contacted from all liability in responding to inquiries in connection with my application.

If I am employed, I understand that false or misleading information given in my application or interview(s) may result in termination. I understand that I am required to abide by all employer rules and regulations.

Date:  

Typing your name here is the equivalent of your signature: 

Chick-fil-A at Surprise Marketplace - 13725 W. Bell Rd., Surprise, AZ. 85374     (623) 584-7795

Call Us, We Deliver!!!  Try Our New Trays For Any Event; Luncheons, Meetings, Dinner Parties, Picnics, Gatherings, and Other Activities!