Employment Application:
Applicant Information
Full Name:
Date:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
Phone:
(
State
ZIP Code
E-mail Address:
)
Date Available:
Social Security No.:
Desired Salary:
$
Position Applied for:
YES
NO
Are you a citizen of the United States?
YES
If no, are you authorized to work in the U.S.?
YES
NO
YES
NO
Have you ever worked for this company?
If yes, when?
Have you ever been convicted of a felony?
If yes, explain:
Education
High School:
Address:
YES
From:
To:
College:
Degree:
Address:
YES
From:
To:
NO
Did you graduate?
Other:
Degree:
Address:
YES
From:
NO
Did you graduate?
To:
NO
Did you graduate?
Degree:
Additional Information and References
Other skills, qualifications, or experience: (software programs, social media, volunteer, etc.)
Please list two professional references.
Full Name:
Relationship:
Company:
Phone:
(
)
Phone:
(
)
Address:
Full Name:
Company:
Address:
Relationship:
NO
Previous Employment
Company:
Phone:
Address:
(
)
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
$
$
Responsibilities:
From:
To:
Reason for Leaving:
YES
NO
May we contact your previous supervisor for a reference?
Company:
Phone:
Address:
(
)
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
$
$
Responsibilities:
From:
To:
Reason for Leaving:
YES
NO
May we contact your previous supervisor for a reference?
Company:
Phone:
Address:
(
)
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
$
$
Responsibilities:
From:
To:
Reason for Leaving:
YES
NO
May we contact your previous supervisor for a reference?
Military Service
Branch:
Rank at Discharge:
From:
To:
Type of Discharge:
If other than honorable, explain:
Disclaimer and Signature
Please read before signing: I certify that my answers are true and complete to the best of my knowledge. If this application leads
to employment, I understand that false or misleading information in my application or interview may result in my release.
I authorize my previous employers, schools, or persons listed as references to give any information regarding employment or
educational record. I agree that this organization and my previous employers will not be held liable in any respect if a job offer is not
extended, or is withdrawn, or employment is terminated because of false statements, omissions, or answers made by myself on this
application. In the event of any employment with this organization, I will comply with all rules and regulations as set by the
organization in any communication distributed to the employees.
I hereby acknowledge that I have read and understand the above statements.
Signature:
Date:
APPLICATION SUPPLEMENTAL QUESTIONNAIRE
1) WHAT IS YOUR FAVORITE BEER AND WHY?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
2) WHAT IS YOUR RESTAURANT/BREWERY AND WHY DO YOU LIKE TO VISIT?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
3) HOW WOULD YOU REACT IF YOU FOUND OUT THAT A FELLOW CO-WORKER
WAS STEALING?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4) RANK THESE TRAITS IN ORDER OF IMPORTANCE, 1-5, WITH 1 BEING THE
MOST IMPORTANT...
___ HONESTY
___INTEGRITY
___EMPATHY
___HARD-WORKING
___RELIABILITY
5) CATS OR DOGS?
______________________________________________________________________