Employment Information for test purposes Location: Emailing to: Personal Information First Name* Last Name* Middle Name Email* Phone Number* Cell Phone* Street Address* City* State/Region* Postal Code* If you are under 16 years of age, please state your birthday Date of Birth* (No one under 16 might be hired) Are you employed now?* YesNo If employed by whom? Business phone for contact May we contact you at work?* YesNo Personal Information Name & Location of High School High School course of study Number of years attending High School Did you graduate High School? YesNo Type of High School degree College Name & Location of College College course of study Number of years attending College Did you graduate College? YesNo Type of College degree Business/Trade/Technical Name & Location of Business/Trade/Technical Business/Trade/Technical course of study Number of years attending Business/Trade/Technical Other special training or skills (languagjes, machine, operations, etc) Did you graduate Business/Trade/Technical? YesNo Type of Business/Trade/Technical degree In Case of Emergency Notify Name* Relationship* Phone* Employment Desired Position Applying For* Pay Expected Type of Position Desired* Part timeFull timeSeasonalTemporal Will you work overtime if asked?* YesNo Date you can start* Are you willing to travel?* YesNo Are you willing to relocate?* YesNo Days and Hours Available Monday From: To: Tuesday From: To: Wednesday From: To: Thursday From: To: Friday From: To: Saturday From: To: Sunday From: To: Legal Are you legally able to be employed in the country?* YesNo (If hired, verification will be required by law) Did any company ever discharge you?* YesNo If yes, give name of company(ies) Reason of discharge Have you ever been convicted of a crime other than a minor traffic violation?* YesNo The existence of a criminal record will not automatically siqualify you form the job for which you are applying. If yes, please explain offense and final disposition U.S. Military Service Branch of service Rank Attained Technical Specialization Type of Discharge Previous Employment Have you ever applied or been employed by this Chicken Express or any other locations?* YesNo Location Date of Employment Position Held Supervisor Name Reason of Leaving Previous Employer Company Name Supervisor Phone Previous Employer 2 Company Name Supervisor Phone Previous Employer 3 Company Name Supervisor Phone