THE STEAK HOUSE
34th & Cornhusker Hwy Lincoln, NE 68504
Fax# 402-466-4897
EMPLOYMENT APPLICATION

DATE
FULL NAME
PRESENT ADDRESS CITY STATE ZIP
PERMANENT ADDRESS CITY STATE ZIP
PHONE NO.	BEST TIME TO CALL
PHONE NO.	BEST TIME TO CALL
APPLYING FOR	SOCIAL SECURITY NO.	DATE OF BIRTH
DATE YOU CAN START	SALARY DESIRED	ARE YOU EMPLOYED?
IF YOU ARE EMPLOYED, MAY WE INQUIRE OF YOUR PRESENT EMPLOYER?	EVER APPLIED TO THIS COMPANY BEFORE?	WHERE? / WHEN?
PRESENT OR PREVIOUS EMPLOYER	DATES OF EMPLOYMENT FROM TO
ADDRESS		TELEPHONE
JOB TITLE AND DUTIES
SALARY /per hr /wk or month	REASON FOR LEAVING
PRESENT OR PREVIOUS EMPLOYER	DATES OF EMPLOYMENT FROM TO
ADDRESS		TELEPHONE
JOB TITLE AND DUTIES
SALARY /per hr /wk or month	REASON FOR LEAVING
PRESENT OR PREVIOUS EMPLOYER	DATES OF EMPLOYMENT FROM TO
ADDRESS		TELEPHONE
JOB TITLE AND DUTIES
SALARY /per hr /wk or month	REASON FOR LEAVING
SCHOOL	DEGREE/COURSE OF	YEARS ATTENDED	DID YOU GRADUATE?
GRAMMAR	.	.	.
HIGH SCHOOL	.	.	.
COLLEGE	.	.	.
OTHER	.	.	.

GENERAL INFORMATION Subjects of special study/research work or special training/skills.
REFERENCE NAME	ADDRESS & PHONE	BUSINESS	YEARS KNOWN
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.	.	.	.
.	.	.	.
.	.	.	.
U.S. MILITARY OR NAVAL SERVICE	RANK
AUTHORIZATION 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. APPLICANT'S SIGNATURE _____________________________________________________ DATE _________________