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 AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest 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?*YesNoIf no, are you authorized to work in the United States?YesNoHave you ever been convicted of a felony?*YesNoIf yes, please explain.Education DetailsName of High SchoolWhen did you attend this high school?Did you graduate from High School?YesNoDid 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?YesNoDegreeAdditional Skills or TrainingPlease list skills and explainDid you serve in the military?Branch of ServiceWhen?Rank at DischargeHonorable Discharge?YesNoOtherIf other than honorable, please explain:Previous EmploymentMost Recent CompanyJob TitleDates of EmploymentAddress City State / Province / Region Supervisor's NameCompany PhoneStarting SalaryEnding SalaryResponsibilitiesReason for leavingMay we contact this employer?YesNoCompany Before ThatJob TitleDates of EmploymentAddress City State / Province / Region Supervisor's NameCompany PhoneStarting SalaryEnding SalaryResponsibilitiesReason for leavingMay we contact this employer?YesNoProfessional ReferencesReference #1: First and Last NameCompanyPhoneRelationshipAddress City State / Province / Region Reference #2: First and Last NameReference #2: First and Last NameCompanyCompanyPhonePhoneRelationshipRelationshipAddress City State / Province / Region Reference #3: First and Last NameReference #3: First and Last NameCompanyCompanyPhonePhoneRelationshipRelationshipAddress City State / Province / Region