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Web Site My Meal The Beer The Service An Employee (Other)

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Which of our restaurants is your comment in reference to?*
Select One contact.hbg@abcbrew.com contact.gb@abcbrew.com contact.ch@abcbrew.com contact.cv@abcbrew.com contact.lititz@abcbrew.com General Comment

Enter your comments in the space provided below:

Tell us how to get in touch with you:

Name:

Email:

Address:

City:

State:

Zip:

 Please contact me as soon as possible.

Do you want to join our mailing list?

 yes no

Position applying for:

FT/PT/Seasonal?

Which of our restaurants is your comment in reference to?*
Select One jobs.hbg@abcbrew.com jobs.gb@abcbrew.com jobs.ch@abcbrew.com jobs.cv@abcbrew.com jobs.lititz@abcbrew.com General Comment

Name:

Social Security Number:

Address:

Street:

City:

State:

Zip:

Email:

Phone:

Cell:

Home:

Note: All prospective employees must submit proof of identity and eligibility for employment in the U. S. prior to appointment. A social security card and driver’s license are preferred.

Have you ever been employed by this company?  yes no

Are you legally eligible to work in the U.S.?  yes no

If you are not a U.S. citizen, are there any restrictions on your eligibility for employment?  yes no

If employed and under 18, can you furnish a work permit?  yes no

Education: Select the highest grade you completed.
 1 2 3 4 5 6 7 8 9 10 11 12

Last high school attended:

Name:

Location:

Date:

Did you graduate?  yes no

If not, have you passed a G.E.D. test?  yes no

Circle the number of post high school education completed.
 1 2 3 4 5 6 7

School

Name:

Location:

Date Graduated:

Major Area of Study:

Special Qualifications and Skills: (Select all that apply)
 typing short hand foreign languages professional licenses & certificates

Do you have a driver’s license?  yes no

Are you able to lift 50 lbs?  yes no

Have you ever been convicted of any offense against the law? Omit juvenile offenses and minor traffic violations. Include convictions by general court martial while in the military service.
 yes no

If yes, please give:

Date:

Place:

Charge:

Court:

Fine or Sentence

A conviction does not automatically mean that you cannot be employed. What you were convicted of and how long ago are important. Give all the facts so that a decision can be made.

Have you ever been fired or asked to resign from a job?  yes no

If yes, give the name and address of employer and describe reason.

Name:

Address:

Reason:

A firing or forced resignation does not automatically exclude you from employment. The circumstances, time elapsed and recent employment record will be considered.

Experience: The selection process for most positions involves an evaluation of relevant education and experience. It is important, therefore, that you provide enough details so that your qualifications can be properly evaluated.

Start with your present job and work back. Additional experience should be listed by attaching separate sheets of paper or a personal resume. Be sure to include all requested information.

Employer:

Dates: From To

Phone:

Avg. Hrs:

Address:

Hrs Per Week:

Job Title

Salary: Starting Ending

Supervisor’s Name:

Reason For Leaving:

Describe your work:

Employer:

Dates: From To

Phone:

Avg. Hrs:

Address:

Hrs Per Week:

Job Title

Salary: Starting Ending

Supervisor’s Name:

Reason For Leaving:

Describe your work:

On what date would you be available for work?

What is your desired rate of pay?

Have you ever served in the military service?  yes no

If yes:

Branch:

Date entered

Date discharged

May we conduct a background check of your qualifications, character and record of employment?
 yes no

If no, please explain:

Certification: This statement must be signed.
I certify that all of the statements made in this application are true and complete to the best of my knowledge. I understand that a false or incomplete answer may be grounds for not employing me, or for dismissing me after I have begun work. I waive all rights I might have against a previous employer who provides references and/or records concerning my employment history. I understand that for certain positions I may be required to successfully complete a credit check, background check, personality test, physical examination and/or alcohol and drug test. I understand that my driving record, fingerprints, and police record may be checked and I may also be subject to signing a non-compete and an employment reference release if I am employed in a sensitive job.

Signature

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