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If you would like a fast-paced job and enjoy working with
great people we'd like to hear from you!


You may also print this form out and mail to:
BJ’s Steak & Rib House
17 North Market Street
Selinsgrove, PA 17870
ATTN: Employment Opportunities Division
PERSONAL INFORMATION/EMPLOYMENT APPLICATION
Date
Social Security
First Last MI
Present Address
City State Zip
Permanent Address
City State Zip
Phone
E-mail
Are you 18 years or older? Yes No
Are you prevented from lawfully becoming employed in this country because of visa or immigration status?
Yes No
If Yes, Explain:
 
EMPLOYMENT DESIRED
Position
Date you can start:
Salary Desired:
Are you employed now?

Yes No

If so, may we inquire of your present employer?

Yes No

Ever applied to this company before? Yes No
Where? When?
Referred by
 
EDUCATION
Grammar School Number of Years attended
Did you graduate? Yes No Subjects Studied
High School Number of Years attended
Did you graduate? Yes No Subjects Studied
College Number of Years attended
Did you graduate? Yes No Subjects Studied
Trade School or Other
Number of Years attended?
Did you graduate? Yes No Subjects Studied
 
GENERAL INFORMATION
Subjects of special study
or research work
Special Skills
Activities
U.S. Military or Naval Service?
U.S. Military or Naval Service Rank
 
FORMER EMPLOYERS
(List below last three employers, starting with last one first)
1. Name & Address of Employer
Date, Month & Year Worked
From
To
Salary: Position
Reason for Leaving
 
2. Name & Address of Employer
Date, Month & Year Worked
From
To
Salary Position
Reason for Leaving
 
3. Name & Address of Employer
Date, Month & Year Worked
From
To
Salary Position
Reason for Leaving
Which of these jobs did you like best?
What did you like most about this job?
 
REFERENCES: Please use the boxes below to list your references. Please list the name, address, business and years acquainted in each box.
Reference #1
Reference #2
Reference #3
In case of emergency notify: (Please list name, address and phone)
Additional Comments:

 

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