Work at Chicken Out Complete the form below for employment consideration. We look forward to the opportunity to work with you. Name* First Last Birth Date* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Employment DetailsAvailable Start Date* Desired Salary / Per Hour* Position Applied For:* Service Staff Cashier Staff Cook/Prep Pit Crew Dishwasher FOH Supervisor Sous Chef BOH Management Are you a U.S. Citizen?* Yes No If no, are you authorized to work in the United States? Yes No Have you ever been convicted of a felony?* Yes No If yes, please explain.Education DetailsName of High School When did you attend this high school? Did you graduate from High School? Yes No Did you attend college or an another institution? If so, list it here. When did you attend this College or Institution? Did you graduate from this College or Institution? Yes No Degree Additional Skills or TrainingPlease list skills and explainDid you serve in the military?Branch of Service When? Rank at Discharge Honorable Discharge? Yes No Other If other than honorable, please explain:Previous EmploymentMost Recent Company Job Title Dates of Employment Address City State / Province / Region Supervisor's Name Company PhoneStarting Salary Ending Salary ResponsibilitiesReason for leavingMay we contact this employer? Yes No Company Before That Job Title Dates of Employment Address City State / Province / Region Supervisor's Name Company PhoneStarting Salary Ending Salary ResponsibilitiesReason for leavingMay we contact this employer? Yes No Professional ReferencesReference #1: First and Last Name Company PhoneRelationship Address City State / Province / Region Reference #2: First and Last Name Reference #2: First and Last NameCompany CompanyPhonePhoneRelationship RelationshipAddress City State / Province / Region Reference #3: First and Last Name Reference #3: First and Last NameCompany CompanyPhonePhoneRelationship RelationshipAddress City State / Province / Region CAPTCHA