Chick-fil-A Ballentine

Employment Application

Please answer the following questions truthfully and to the best of your ability.

Section 1: Tell Us About Yourself
First Name
Middle Initial
Last Name
Preferred Name
Current Address
Zip Code
Phone Number
Do you have a reliable means of transportation to work?
What wage rate are you expecting?
Are you younger than 18 years old?
Section 2: Availability

* Please choose days and times available to work below *

Day Evening Night
Do you have limitations to your availability?
Are you interested in a Full-Time position?
Are you interested in a Part-Time position?
Are you looking for a Seasonal position?
Are you looking for an All-Year position?
Minimum weekly number of hours needed to work
Maximum weekly number of hours needed to work
Section 3: Previous Employment History
Have you ever worked for a Chick-fil-A, Inc. or a Chick-fil-A Franchisee?
If YES, which location previously employed you?
Please list your two (2) most recent jobs

You may include babysitting, lawn care, volunteering, etc. if this will be your first job experience with an employer.

Name of Employer
Email Address of Employer
Employed from
Phone Number
Reason for Leaving

Name of Employer
Email Address of Employer
Employed from
Phone Number
Reason for Leaving
Section 4: Education
High School (last attended)
Did you graduate?
If NO, are you currently attending High School?
College & Vocational Schools
Did you Graduate?
If YES, Degree & Major?
Grade Point Average
Section 5: Personal Background

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

Award and/or Leadership Position - 1
Award and/or Leadership Position - 2
Award and/or Leadership Position - 3
Section 6: Military Service
Have you served in the military?
Start Date
End Date
Relevant Skills
Section 7: References

* Please refrain from providing family members and/or relatives as references *

Phone Number
Years Known

Phone Number
Years Known
Please Read the Following Statements Carefully and Sign Digitally

* Signature is Digital *

I understand that I am applying for employment at this particular Chick-fil-A Restaurant location only and this location is operated by an independent franchisee (the 'Franchisee'). I further understand that completion of this application does not indicate that there are any positions currently open and 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 personally completed this application. I understand that providing false or misleading information or omitting pertinent information in my application or a job 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 definite period of time. I understand that my employment may be terminated 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 all performance reviews, reports, and other documents and information related to my background, work history and qualifications, without giving me prior notice of such disclosure. I also authorize the persons named herein as references and others of whom the franchisee may inquire about my background to provide the Franchisee with any pertinent information they may have regarding me. By signing below, I fully release the Franchisee, 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 to such references or disclosures.
Date Completed
This Chick-fil-A Franchisee is an equal employment opportunity employer and considers all applicants without regard to race, color, religion, national origin, ancestry, citizenship, sex, pregnancy, age, physical or mental disability, genetic information, service in the uniformed services, and/or any other protected status, classification or factor, in accordance with the requirements of all federal, state and local laws. Applicants requiring reasonable accommodations to the application and/or interview process should notify the Franchisee.