APPLICATION FOR EMPLOYMENT

Wooden Legs Brewing Company, LLC.

309 5th Street, Suite 100

Brookings, SD 57006

employment@woodenlegsbrewing.com | 1-605-692-BEER (2337)

Wooden Legs Brewing Co. is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status.

Name:

Date:

Email:

SSN#:

Full Address:

Phone:

Position desired:

Referral Source (how did you hear about this opening?):

Are you over the age of 21?:  Yes [ ] No []

(If no, you may be required to provide authorization to work.)

Are you legally eligible to be employed in the United States? YES [ ] NO [ ]

(Proof of identity and eligibility will be required upon employment)

Can you perform the essential functions of the position?  YES [ ] NO [ ]
If no, please explain.
 (If you have any question as to what functions are applicable to the position for which you are applying, please ask the interviewer before you answer this question)

Have you ever worked for this Company before? YES [ ] NO [ ]

If yes, When? (Give dates)____________________ Job Title: ______________________

Do you have any relatives or friends who work for the Company? YES [ ] NO [ ] If yes, who and when?

When would you be available to begin work?

Are you available to work: DAYS [ ] NIGHTS [ ] WEEKENDS [ ] FULL TIME [ ]

Days and Hours Available:

(If employed, I will notify my supervisor in writing, should my availability change.)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Are you presently employed? YES [ ] NO [ ]

If yes, may we contact your employer? YES [ ] NO [ ]

If presently employed, why are you considering leaving?

Have you ever done any volunteer work? YES [ ] NO [ ] If yes, describe:

(Omit any volunteer work which reflects your race, color, religion, age, sex, sexual orientation, marital status or disabilities)

Do you belong to any professional, trade, business or civic organizations that deal with the position for which you are applying? YES [ ] NO [ ] If yes, please explain and list offices held:

(Omit any organization which reflects your race, color, religion, age, sex, sexual orientation, marital status or disabilities.)

Have you completed any special courses, seminars and/or training that would enable you to perform the position for which you are applying? YES [ ] NO [ ] If yes, please describe:

Account for any full month since leaving school (high school or college) that you were not working:

From (Month/Year)

To (Month/Year)

Reason

Education History

Name or Location of School

Course of Study

No. of Years Completed

Diploma or Degree Received

High School

Trade or Vocational School

College

College

Postgraduate

List academic honors, extracurricular activities, offices held, etc. in high school or college:

(Omit any which reflects your race, color, religion, age, sex, sexual orientation, marital status or disabilities.)

Employment History: (Start with your most recent position)

Name of Employer:

Telephone Number:

Full Address: (including Street, City and Zip code)

Supervisors Name and Title:

Dates Employed: (Month/Day/Year)

to

Pay Rate: (Beginning and Final)

Describe work performed:

Reason for Departure:

Name of Employer:

Telephone Number:

Full Address: (including Street, City and Zip code)

Supervisors Name and Title:

Dates Employed: (Month/Day/Year)

to

Pay Rate: (Beginning and Final)

Describe work performed:

Reason for Departure:

Name of Employer:

Telephone Number:

Full Address: (including Street, City and Zip code)

Supervisors Name and Title:

Dates Employed: (Month/Day/Year)

to

Pay Rate: (Beginning and Final)

Describe work performed:

Reason for Departure:

Use an additional sheet of paper if more space is necessary.

Personal Referencese

Give three references (not relatives or employers)

Name:

Occupation:

Full Address:  (Including Street, City, State & Zip)

Telephone Number:

Name:

Occupation:

Full Address:  (Including Street, City, State & Zip)

Telephone Number:

Name:

Occupation:

Full Address:  (Including Street, City, State & Zip)

Telephone Number:

IMPORTANT, PLEASE READ AND SIGN

I understand that failure to reveal any prior employer, or giving false or misleading information by me on any part of this Application for Employment can be grounds for termination from the company or its' subsidiaries. I understand that if I am hired, my employment is for no definite time and may be terminated at any time without

prior notice.

Signed: ________________________________________________ Date:_______________________

THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE SIGNED/DATED ABOVE.

Wooden Legs Brewing Company Use Only:

Interviewed by:

Interview Date:

Employed: YES [] NO []

Job Title:

Date Beginning Employment:

Compensation $       per  

General Notes:

Last Name:                                                                                             Page:/

Date:                                                                                                 Ver. 13.3.12

Wooden Legs Brewing Co. Application for Employment