Employment - Dixie Roadhouse

Dixie Roadhouse Employment Application 2026

Are you a U.S. Citizen or alien authorized to work in the United States?

Yes No

Have you ever been convicted of a felony?

Yes No

Are you curently employed?

Yes No

If Yes, may we contact your current employer?

Yes No

Have you ever applied to this company before?

Yes No

Subjects of Special Study

Special Training / Skills

US Military or Naval Service?

Yes No

Present membership in National Guard or Reserves?

Yes No

How are you acquainted?

Would This be a Secondary Job?

Yes No

If Yes, how many hours do you work at your other job?

How Many Shifts per week do you want here?

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter in to any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. I understand that my employment is at will and can be dismissed within the first 30 working days for any reason and without warning.”

Authorization Agreement

I Agree

Phone Number

Hours

Address