First Name Last Name Address E-mail Phone
First Name
Last Name
Address
E-mail
Phone
Which location will you be applying?
Gretna - 20596 West Hwy 370 Omaha - 14208 S Street Omaha - 6922 N. 102nd Circle Omaha - 18010 R Plaza Omaha - 2062 N. 117th Ave Omaha - 541 N. 155th Ave. Omaha - 2416 Cumings Ave. Norfolk - 2600 W. Norfolk Ave. Omaha - 7461 Cass Street Omaha - 1125 Jackson Street Ralston - 5352 S. 72nd Street Lincoln - 1501 Pine Lake Rd Suite 10 Elkhorn - 109 Hillrise Center Elkhorn - 2949 N. 204th Street Blair - 1995 Ridgeview Road Lincoln - 4131 Pioneer Woods Drive
Which position will you be applying?
Server Busser Kitchen Staff Bartender Are you over 18 to serve alcohol? ( 19 in NE) Yes No
Server Busser Kitchen Staff Bartender Are you over 18 to serve alcohol? ( 19 in NE)
Yes No
Have you ever been employed with Sam and Louie's?
Type of Employment Desired
Full Time Part Time Hours of Availability References
Full Time Part Time
Hours of Availability
References
Qualifications / Employment History
