Application

Today's Date

Name

First

Last

Street Address

City, State and Zip Code

Telephone Number

Email Address

Position(s) applying for (select all that apply):

Management
Line Cook/Kitchen
Cashier/Server

How did you hear about this position?

How many hours per week are you interested in working? (copy)

What days are you available for work?

If needed, are you available to work overtime?

On what date can you start working if you are hired?

Do you have reliable transportation to and from work?

Do you have any friends, relatives or acquaintances working at KOTO?

If yes, state name and relationship:

Are you 19 years of age or older?

Do you have any condition which would require job accommodations?

If yes, please describe accommodations required below.

(Note: Koto Brewing Company complies with ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)

Why do you want to work for us?

Why should we hire you?

Previous Employment (1)

Job Title

Supervisor Name

Employer Street Address

City, State and Zip Code

Employer Telephone

Dates Employed

Reason for Leaving

Previous Employment (2)

Job Title

Supervisor Name

Employer Street Address

City, State and Zip Code

Employer Telephone

Dates Employed

Reason for Leaving

Reference 1

Reference Name

Reference hone Number

Phone Number

Reference Relationship

Relationship

The relationship between you and Koto Brewing Company is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or Koto Brewing Company. No representative of Koto Brewing Company has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our President, Vice President or General Manager.

Applicant Signature (electronic)

Date

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