You are on page 1of 1

2030 Main Street, Suite 1300

Irvine, CA 92614

Last Name Jones  First Stephen M.I. A 01/05/2010
If no, are you authorized to work in the
Are you a citizen of the United States? YES NO YES NO
Have you ever been convicted of a If yes,
YES NO      
Misdemeanor or felony? explain


Company: Miller Brewing Company Company: Miller Brewing Company

Name: Reggie Hayes Name: Mark Selby
Job Title: Assistant Plant Manager Job Title: Director of Financial Planning
Phone: 626-969-6800 Phone: 414-931-2000
Email: <Email> Email: <Email>
Relationship: Professionally Relationship: Professionally


Company: Miller Brewing Company Company: Miller Brewing Company

Name: Shelia Garrett Name: Vicki Hayes
Job Title: I.S. Manager Job Title: Employee Relation
Phone: 626-969-6800 Phone: 626-969-6800
Email: <Email> Email: <Email>
Relationship: Professionally Relationship: Professionally

(if applicable)

Company: Georg Fisher Company: <Current Company>

Name: Cathy Miller Name: <First and Last Name>
Job Title: Accounting Support Job Title: <Current Title>
Phone: 909-762-4929 Phone: <Current Number>
Email: <Email> Email: <Email>
Relationship: Professionally Relationship: <How You Know Eachother>


Certification & Reference Authorization: I have provided a resume and references to VincentBenjamin Irvine, LLC (VBI) for
the purpose of obtaining assistance in securing employment. I certify that all of the information contained in this form, any other
documents filled out in connection with my employment, and any information provided in any interview, is true, complete and
correct, and understand that any misrepresentation, omission or falsification of this application or any information provided by
me may result in my disqualification from further consideration for employment or, if hired, dismissal from employment. I
expressly authorize VBI to contact my former employers, references, and any and all other persons and organizations for
information bearing upon my qualifications for employment.

Signature Stephen Jones Date 01/05/2010

VincentBenjamin Irvine, LLC (VBI) is an equal opportunity company. VBI considers registrants for all positions without
discrimination on the basis of race, color, religion, sex, national origin, age, disability, marital status, or veteran status, or
any other legally protected status. No question on this website is used for the purpose of limiting or excluding any applicant's
consideration for job placement on any basis prohibited by local, state, or federal law.