Employment Application Apply to join the Koors Team Today! All boxes must be filled in or marked N/A Position You Are Applying For Desired Salary Date Available For Work Personal Information First Name Middle Last Name Address City State Zip Home Phone Cell Phone Email Address Are you a U.S. Citizen?YesNo Have you ever been convicted of a felony?YesNo If selected for employment are you willing to a pre-employment drug screening test?YesNo Education School Name Location Years Attended Degree Received Major ----------------------------------------------------------------------- School Name Location Years Attended Degree Received Major Other training, certifications or licenses held: ----------------------------------------------------------------------- Employment Employer Dates Employed Work Phone Starting Pay Rate Ending Pay Rate Address City Position Duties Performed Supervisor's Name and Title Reason for Leaving May we contact them?YesNo ----------------------------------------------------------------------- Employer Dates Employed Work Phone Starting Pay Rate Ending Pay Rate Address City Position Duties Performed Supervisor's Name and Title Reason for Leaving May we contact them?YesNo References Name Title Company Phone ----------------------------------------------------------------------- Name Title Company Phone ----------------------------------------------------------------------- Name Title Company Phone Acknowledgement and Authorization I certify that all answers given herein are true and complete to the best of my knowledge. Yes I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. Yes In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. Yes Electronic Signature (type your name) Date
