Resurgence Brewing Company

AN EQUAL OPPORTUNITY EMPLOYER

Resurgence Brewing Company’s policy prohibits discrimination on the basis of race, color, religion, sex, national origin, age, creed, marital status, sexual orientation, genetic predisposition, carrier status, military service, veteran status, physical or mental handicap or disability, arrest/conviction status, or other legally protected status in accordance with all applicable federal and state laws.

Your Name*

First Last

Your Address*

Street Address Address Line 2 City State ZIP Code

Phone Number*

Email*

Position Applying For*

Full or Part Time

Date Available to Start*

Salary Range Desired

If under age 18, do you have a work permit?

Yes
No

If you are not a United States Citizen, do you have the legal right to work in the United States?*

Yes
No

List the names of any relatives employed by Resurgence Brewing Company:

How were you referred to Resurgence Brewing Company?*

In the event of an emergency, who should we contact?

Emergency Contact Name*

Emergency Contact Phone*

Emergency Contact Address*

EDUCATIONAL BACKGROUND

Level of Education*

High School
College
Graduate School
License or Certification
Other

Do you have a degree?*

Yes
No

List School Names

List Majors

EMPLOYMENT BACKGROUND

List the names of all your employers starting with current or most recent.

EMPLOYMENT #1

Company Name

Company Address

Company Phone Number

Job Title

Dates Employed

Name of Supervisor

Reason for Leaving

EMPLOYMENT #2

Company Name

Company Address

Company Phone Number

Job Title

Dates Employed

Name of Supervisor

Reason for Leaving

EMPLOYMENT #3

Company Name

Company Address

Company Phone Number

Job Title

Dates Employed

Name of Supervisor

Reason for Leaving

REFERENCES

Please provide the name, address, and telephone number of three references who are qualified to evaluate your capabilities and who are not related to you.

REFERENCE #1

Name

Email

Phone

REFERENCE #2

Name

Email

Phone

REFERENCE #3

Name

Email

Phone

AVAILABILITY

Indicate the times you are available each day.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

UPLOAD RESUME

File Types Accepted: jpg, png, pdf, doc, docx*

APPLICANT’S STATEMENT

Please read statement and check the box below to agree.*

I understand that if I am employed, employment is at-will and may be terminated at any time without cause or notice. A routine inquiry may be made which will provide information concerning your job background and qualifications for available positions. Upon written request, information as to the nature and scope of the report, if one is provided, will be made available to you.

I certify the information I have given is accurate and complete to the best of my knowledge. I authorize you to process my application. I further understand that if I am employed, any misrepresentation of facts on this application is sufficient cause for dismissal.

Yes, I understand.

CAPTCHA

Employment Application

AN EQUAL OPPORTUNITY EMPLOYER

EDUCATIONAL BACKGROUND

EMPLOYMENT BACKGROUND

REFERENCES

AVAILABILITY

UPLOAD RESUME

APPLICANT’S STATEMENT