Resurgence Brewing Company Buffalo NY

Application

EMPLOYMENT APPLICATION

AN EQUAL OPPROTUNITY 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 Full Name
Phone Number
* Cell Phone
*Email Address
*Position Applied For
*If you are not a United States Citizen, do you have the legal right to work in the United States?
YesNo
Please explain any disability you have which would substantially interfere with you ability to perform the
essential functions of the job from which you have applied?
List the names of any relatives employed by Resurgence Brewing Company
*How were you referred to Resurgence Brewing Company?
In case of emergency, notify

EDUCATIONAL BACKGROUND

*Level of Education
High SchoolCollegeGraduateOtherLicense or Certification
Degree
YesNo
List School Names
List Majors

EMPLOYMENT BACKGROUND

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


Employment #1

Name of Supervisor
Reason for Leaving

Employment #2

Name of Supervisor
Reason for Leaving

Employment #3

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

Reference #2

Reference #3

AVAILABILITY

(indicate the times you are available each day)

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Upload Resume

Files accepted: jpg, png or pdf

APPLICANT’S STATEMENT

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