Southwest Wines - Employment Application
Southwest Wines - Employment Application
This application must be completely filled out to be a candidate for any job openings. Please enter "none" or "N/A" for any fields that are not applicable to you.

Last Name*
First Name*
Middle Initial*
Date*
Street Address*
Apartment/Unit #
City*
State*
Zip Code*
Phone #*
Email address*
Desired Salary*
Date Available to work*
Position Applied for*
Are you over 18 years of age?*
Yes 
No 
Have you ever worked for this company before?*
Yes 
No 
If so, when?



EDUCATION
High School*
Address*
From*

MM		/
DD		/
YYYY
Did you graduate?*
Yes 
No 
Degree

College*
If none, state "none"
Address
From

MM		/
DD		/
YYYY
To

MM		/
DD		/
YYYY
Did you graduate?
Yes 
No 

Other Education
Address
From

MM		/
DD		/
YYYY
To

MM		/
DD		/
YYYY
Did you graduate?
Yes 
No 
Degree/Certificate


REFERENCES
Reference #1
Full Name*
Company*
Relationship*
Phone #*
Address

Reference #2
Full Name*
Company*
Relationship*
Phone #*
Address

Reference #3
Full Name*
Company*
Relationship*
Phone #*
Address

PREVIOUS EMPLOYMENT
Company #1*
Address
Job Title*
Supervisor*
Starting Salary*
Ending Salary*
Responsibilities*
From

MM		/
DD		/
YYYY
To

MM		/
DD		/
YYYY
Reason for leaving*
May we contact your previous supervisor for a reference?*
Yes 
No 

PREVIOUS EMPLOYMENT
Company #2*
If none, type "none"
Address
Job Title
Supervisor
Starting Salary
Ending Salary
Responsibilities
From

MM		/
DD		/
YYYY
To

MM		/
DD		/
YYYY
Reason for leaving
May we contact your previous supervisor for a reference?*
Yes 
No 

PREVIOUS EMPLOYMENT
Company #3*
If none, type "none"
Address
Job Title
Supervisor
Starting Salary
Ending Salary
Responsibilities
From

MM		/
DD		/
YYYY
To

MM		/
DD		/
YYYY
Reason for leaving
May we contact your previous supervisor for a reference?
Yes 
No 

MILITARY SERVICE
Branch*
If none, type "none"
From

MM		/
DD		/
YYYY
To

MM		/
DD		/
YYYY
Rank at discharge
Type of discharge
If other than Honorable, explain
DISCLAIMER AND CERTIFICATION
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to my employment, I understand that false or misleading information in my application or interview may result in my release*
I agree 
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1325 DeBaca Rd. SE
Deming, NM 88030
575.546.9324
1.888.SWWINES
info@southwestwines.com