KFC Employment Application Form

Application for Employment
Personal Information
Name*

Given NameLast Name
Birth Date

MonthDayYear
Email*
example@example.com
Phone Number*
Do you have any relatives working in our company?*

YesNo
If yes, state their name and relation:
Referred by:
Nationality*
Do you have a valid food handler's permit?*

YesNo
Address*

Street Address

Street Address Line 2

CityCountry

Postal / Zip CodeCountry
Gender*

MaleFemale
Marital Status*

MarriedSingleWidowedDivorcedSeparated
Photo*

Must be a passport style photo.
Cancelof
Employment Desired
Full timePart time
Expected wage*
Are you employed now?*

YesNo
If so, may we enquire of your present employer?

YesNo
Present salary
Have you applied here before?

YesNo
When?

	Name & Location of School	Years Attended	Date Graduated
Grade School
College
Trade, Business or Correspondence

What languages can you speak fluently?
Special activities

List your three most recent jobs

	Employer	Position	Reason for Leaving	From	To
1
2
3

References

Please list two (2) references who are familiar with your work life.
Reference
Reference
Physical Record
Do you have any defects of

HearingVisionSpeech
Do you have any health problems we should be aware of?

In case of emergency, notify

	Name	Address	Telephone No.
Contact 1
Contact 2

I understand that misrepresentation or omission of facts is cause for immediate dismissal

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Date

MonthDayYear
Should be Empty: