Employment Application
Your Information
First Name   Last Name             

Enter your e-mail address

Street   City   State   Zip

In Case of Emergency Notify:

Name Relation Phone  
Street City State Zip  

Employment Information

Position desired:

Date Available:

Are you currently employed?   

Yes   No
What hours can you work?

Number of hours you wish to work

Days you wish to work: Mon  Tue  Wed  Thu  Fri  Sat  Sun 

Do you have any previous restaurant experience?  Yes

Have you ever applied to or worked for Chicago Fire? Yes
Which Location?
When did you work?
Reason for leaving

Do you have any friends or relatives working for Chicago Fire? Yes
If yes, state name(s) and relationship:

Why are you applying for work at Chicago Fire?
If hired, would you have a reliable means of transportation to/from work? Yes
Are you at least 18 years old? Yes
(if under 18, hire is subject to verification that you are of minimum legal age.)

If hired, can you present the essential functions and all other duties of the job for
which you are applying? Yes

If no, describe the duties and functions that you cannot perform:

Have you ever been convicted of a felony? Yes
If yes, state nature of the crime(s), when and where convicted, and disposition of the case:

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding
circumstances and the relevance of the offence to the position(s) applied for may, however, be considered.)


Education, Training & Experience

School Name & Address No. Of Years
Did You
Degree Or
High School Yes
College/University Yes
Vocational/Business Yes
Other Yes


Do you speak, write or understand any foreign languages?

Do you have any other experience, training, qualifications or skills which you feel make you
especially suited for work at Chicago Fire?


Employment History

List below all present and past employment starting with your most recent employer:

  Date of Employ. Name/Location Position/Duties Salary Reason For Leaving

To: May we contact?  Yes
To: May we contact?   Yes
To: May we contact?   Yes
To: May we contact?   Yes



List below three persons, who are not relatives, whom you have known for at least one year:
Name & Address Telephone

Please Read (application certification, authorizations and understandings):

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I agree that if I am made an offer of employment with Chicago Fire, my employment can be terminated "at-will" by me or the company for any reason or no reason. Any agreement that alters the at-will employment relationship must be in writing and signed by both me and the company president. This is a integrated agreement regarding the at-will nature of my employment.

I hereby authorize Chicago Fire to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and further, authorize my former employers to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release Chicago Fire, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.