Join Our Team - Electric Brew

Personal Information

Full Name *

Phone *

Date of Birth *

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Address *

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City

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Availability

Availability to Start *

Desired Salary

Preferred Location (check all that apply)

Goshen
Ivy Tech Elkhart
Elkhart

Desired Shift/Hours (check all that apply) *

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Education

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Did your graduate? *

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College

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Employment History

Company 1 Name *

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Supervisor

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Job Responsibilities and Achievements

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Reason for Leaving

May we contact our previous supervisor for a reference? *

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Company 2 Name *

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Supervisor

Job Title

Job Responsibilities and Achievements

Date Started

Date Left

Reason for Leaving

May we contact our previous supervisor for a reference?

Yes
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References

Reference 1 Name *

Relationship *

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Reference 2 Name *

Relationship *

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Email *

Consent and Agreement

I certify that my answers are true and complete to the best of my knowledge. *

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If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. *

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Applicant's Signature *

Date of Application *