Application

Application

Please print off this form and mail or fax it to us at the address below.

Personal Information

Name		Social Security Number

Present Address	City	State	Zip

Present Address	City	State	Zip




Phone No.		Referred By:

Employment Desired

Position	Date You Can Start			Salary Desired

Are You Employed?			If So, May We Inquire of Your Present Employer
Yes No			Yes No
Ever Applied to the Big Ten Before?		Where?		When?
Yes No

Education History

Name & Location of School	Years Attended	Did You Graduate	Subject Studied
Grammar School
High School
College
Trade or Business School

General Information

Subject of Special Study/Research Work or Special Training



U.S. Military or Naval Service	Rank

Former Employers (List Most Recent First)

Date Month and Year	Name & Address of Employer	Salary	Position	Reason For Leaving
From
To
From
To
From
To
From
To

References List 3 Persons That Are Not Related to You and That You Have Known For at Least a Year.

Name	Address	Business	Years Known

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.

I also understand and agree that no representative of the company has any authority to enter into 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.”

Date____________ Signature_________________________________

Mail or Fax

Big Ten Restaurant

610 Washington Ave S

Minneapolis. MN 55414

Fax: (612) 378-0128

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