Steak And Shake Application – Fill Out and Use

PERSONAL INFORMATION

Today's Date

11/1 3 /73

Name

301-78 -8773

Last

First

Middle

Social Security Number

Other names, by which you have been known

Address

Number

Street

City

State

Zip code

Home Telephone Number

(419

)

Work (or message) Telephone Number

(41 9 )

Area Code

Number

Area Code

Number

Are you legally eligible to work in the U.S.?

❑ Yes

❑ No

POSITION DESIRED

What kind of position are you applying for?

(Check One)

❑ Service

❑ Production

What type of employment do you want?

(Check One)

❑ Full Time

❑ Part Time

❑ Temporary

What are the two (2) most important factors to you in choosing a job? 1.

What are your wage expectations per hour?

$

2.

WORK SCHEDULE

What is the minimum (fewest) number of hours you would consider acceptable? Per Week

Per Day

Can you work a flexible schedule? (Days and number of hours scheduled are different every week) ❑ Yes

❑ No

What schedule are you available to work? (Time- Include AM or PM)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

From

To

From

To

From

To

From

To

From

To

From

To

From

To

OTHER INFORMATION

Have you been convicted of a crime

❑ Yes

List all convictions, showing offenses and date:

(other than minor traffic violations)?

❑ No

The applicant is not obligated to disclose sealed or

expunged records of conviction or arrest.

In your prior employment, have you had

❑ Yes

If yes, please describe fully:

shortages or misunderstandings about

❑ No

merchandise or funds?

Have you ever been terminated from a

❑ Yes

If yes, list dates and explain:

job or asked to resign?

❑ No

Do you have transportation?

❑ Yes ❑ No

Can you perform the essential functions of the job for which you are applying, with or without reasonable accommodation?

❑ Yes

❑ No

What restaurant or office equipment do you operate?

Special licenses/certificates earned:

Have you ever worked for Steak n Shake? ❑ Yes ❑ No

If yes, when and where?

Do you have any relatives working for Steak n Shake? ❑ Yes ❑ No

If yes, name and location:

Employment Source:

❑ Classified ad

❑ Walk-in

❑ School/College

❑ Other:_______________________________

❑ Former employee

❑ Agency

❑ Employee referral-__________________________________________

Name

Company:

Telephone Number:

Your Position:

Address:

Duties:

Dates Employed:

Supervisor:

Supervisor Title:

Reason For Leaving:

Earnings (Starting/Ending)

Company:

Telephone Number:

Your Position:

Address:

Duties:

Dates Employed:

Supervisor:

Supervisor Title:

Reason For Leaving:

Earnings (Starting/Ending)

Company:

Telephone Number:

Your Position:

Address:

Duties:

Dates Employed:

Supervisor:

Supervisor Title:

Reason For Leaving:

Earnings (Starting/Ending)

EDUCATION

High School (or G.E.D.):

G.P.A.:

Graduate?

Major course of study:

(name and address)

❑ Yes ❑

No

College:

G.P.A.:

Graduate?

Major course of study:

(name and address)

❑ Yes ❑

No

Graduate School:

G.P.A.:

Graduate?

Major course of study:

(name and address)

❑ Yes ❑

No

Have you taken any other specialized courses/seminars? ❑ Yes ❑ No

If yes, please describe:

CHARACTER REFERENCES: Give three (3) references who are not relatives or former employers

Name:

Occupation:

Years Known:

Telephone Number:

Name:

Occupation:

Years Known:

Telephone Number:

Name:

Occupation:

Years Known:

Telephone Number:

Number

Street

City

State

Zip code