cfa team member application

7/28/2019 CFA Team Member Application

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CALIFORNIA

PLEASE TELL US ABOUT YOURSELF

Name (print) Last ____________________________________ Middle I._____ First ________________________________Date ___________

Present Address _____________________________________ City ________________________________ State _______ Zip ____________

Home Telephone _______________________________________ Cell/Other Telephone (if applicable) ________________________________

Email Address ______________________________________________________________________________________________________

Do you have a reliable means of transportation to work? oYes oNo What wage are you expecting? _______________________

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

Are you legally authorized to work in the U.S.? oYes oNo (PROOF OF ELIGIBILITY IS REQUIRED UPON EMPLOYMENT)

Note: In answering the following question, you should not answer yes for any conviction that resulted in a referral to and participation in any pret

or post diversion program pursuant to California Labor Code Section 432.7, any conviction specied in California Labor Code Section 432.8 (whi

pertains to certain marijuana offenses that are more than two years old), and any conviction that occurred when you were a minor that has be

expunged or sealed by the court. A yes response will not necessarily disqualify an applicant from employment. Failure to answer this quest

accurately could cause denial of employment or termination of employment.

Have you ever been convicted of, or pleaded guilty or nolo contendere (no contest) to, a crime other than a minor trafc violation? (DUI is not a

minor trafc violation.) oYes oNo

If so, please indicate the crime, date of conviction, nature of circumstances, state in which offense occurred, and sentence (if any): __________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

AVAILABILITY

MON TUE WED THU FRI SAT

FROM

TO

PREVIOUS EMPLOYMENT HISTORY

Have you ever worked for Chick-l-A, Inc. or a Chick-l-A Franchisee? oYes o No If YES, which Unit? _________________________

PLEASE LIST YOUR THREE MOST RECENT JOBS (including babysitting, lawn care or volunteer work):

Name & Address of Employer __________________________________________________________________________________________

Employed From To Phone # Supervisor Earnings Reason for Leaving

_____________ _______________ _______________________ _______________________ _______________ _________________


Employed From To Phone # Supervisor Earnings Reason for Leaving_____________ _______________ _______________________ _______________________ _______________ _________________


Employed From To Phone # Supervisor Earnings Reason for Leaving_____________ _______________ _______________________ _______________________ _______________ _________________

Relevant skills ______________________________________________________________________________________________________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

oSeasonal oAll Year

Minimum number of hours needed to work ________________

Maximum number of hours able to work __________________

APPLICATION

FOR

EMPLOYME

NT

FRANCHISED LOCATION

7/28/2019 CFA Team Member Application

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APPL

ICATION

FOR

EMPLOYME

NT(CONTINUED)

EDUCATION

High School (Last attended) Location Did You Graduate? oYes oN

__________________________________________________________________________________________________________________

College & Vocational Schools Location Did You Graduate?oYes oNo If yes, Degree & Major Grade Pt. Avera__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

PERSONAL BACKGROUND

Please list job-related awards and/or leadership positions held (work or school) ___________________________________________________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

MILITARY SERVICE

oYes

oNo Branch _____________________ Rank____________________________ Start Date ___________ End Date __________

Relevant skills ______________________________________________________________________________________________________

__________________________________________________________________________________________________________________

REFERENCES

PLEASE PROVIDE FOUR REFERENCES (FOR EXAMPLE, CURRENT OR PAST EMPLOYERS OR SUPERVISORS; TEACHERS;

OTHERS FAMILIAR WITH YOUR JOB QUALIFICATIONS).

Name Address Phone Relationship Years Know

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND SIGN

I understand that I am applying for employment at this particular Chick-l-A Restaurant location only and this location is operated

independent franchisee. I further understand that completion of this application does not indicate that there are any positions currently open a

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 persona

completed this application. I understand that providing false or misleading information or omitting pertinent information in my application or a

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 denite period of time. I understand that my employment may be termina

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

performance reviews, reports, and other documents and information related to my background, work history and qualications, with

giving me prior notice of such disclosure. I also authorize the persons named herein as references and others of whom franchisee may inqu

about my background to provide franchisee with any pertinent information they may have regarding me. By signing below, I fully release franchis

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

such references or disclosures.

_____________________ ____________________________________________________________________________________

Date Applicant Signature

Chick-l-A, Inc. is an equal employment opportunity employer and considers all applicants without regard to sex, race, color, religion, national ori

ancestry, citizenship, pregnancy, age, physical or mental disability, service in the uniformed services, gender, genetic information, marital stat

medical condition, sexual orientation, and/or any other protected status, classication or factor, in accordance with the requirements of all fede

state and local laws.

California 2006-2012 CFA Properties, Inc. Chick-l-A and Chick-l-A Stylized are registered trademarks of CFA Properties, Inc. [Rev. 11-12]

cfa team member application

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