THE VINTNER GROUP > Careers > Employment Application

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Employment Application

general instructions

All information you submit is subject to verification. Notify The Country Vintner advance if you require special disability accommodations to participate in the employment process.

position applied for:

date available:

desired pay:

1. general info

How do we contact you?

Fields with (*) are required

*social security number:

Please enter social security number

*first name:

Please enter your first name

*last name:

Please enter your last name

street address:

*city:

Please enter your city

*state:

*zip code:

Please enter your state Please enter your zip code

*home phone:

Please enter your phone number

*cell phone:

Please enter your cell phone

availability:

Days:

Hours:

Type of Employment Desired:

how did your hear about the country vintner:

NewsPaper
Online
Sign outside employer
Referred by Employee

If so, who?:

2. education

High School

*name of school:

Please enter your name of school

*city school:

Please enter your city school

received:

DiplomaOther

your name, if different while attending school:

College, University or Professional/trade School

name of school:

location:

course of study:

degree:

your name, if different while attending school:

3. previous employment

Please list most recent first:

Describe your work experience in detail, beginning with your current or most recent job. Include military service (indicate rank) and job-related volunteer work, if applicable. Indicate number of employees supervised. Use a separate block to describe each position or grap in employment. All information in this section must be completed.

Resumes may be attached to provide additional information, but can not be used as a substitute for completing this section.

*name of present or last employer:

Please enter name of present or last employer

*street address:

Please enter your street address

*phone number:

Please enter your phone number

*job title:

Please enter your job title

*dates of employment:

Please enter dates of employment

*supervisor:

Please enter supervisor

*Pay:

starting:

ending:

Please enter pay

*duties and responsibilities:

Please enter duties and responsibilities

*reason for leaving:

Please enter reason for leaving

*May we contact
this employer?

YesNo

4. knowledge / skills / abilities (ksa's)

List KSA'S you possess and believe relevant to the position you seek, such as operating heavy equipmet, computer skills, fluency in languages, etc.

5. licensure, registration, certification

Examples: Commercial Driver's Licence, CPA, etc.

License, registration or certification

number

date issued

expiration date

state

6. BACKGROUND INFORMATION

* Have you ever been convicted of a felony?

YesNo

Please enter background informaction

If Yes, what charges?:

where convicted:

Date of conviction:

* Have you ever been convicted of misdemeanor?

YesNo

Please enter your ...

If Yes, what charges?

where convicted:

Date of conviction:

Note: A “yes” answer to these questions will not automatically ban you from employment. The nature, job-relatedness, severuty and date of the offense in relation to the position from which you are applying are considered.

7. CITIZENSHIP

The Country Vitner hires only U.S. citizens and lawfully authorized alien workers. If an offer of employment is made, you will be required to provide identification and proof of citizenship or authorization to work in the U.S.

* Are you a U.S. Citizen or are you legally authorized to work in the U.S.?

YesNo

8. relatives

* To your knowledge, do you have any relatives working for The Country Vintner?

YesNo

If yes, who?:

Please enter your ...

9. references

Please list two references other than relatives or previous employers

*Name:

Please enter name

*ADDRESS:

Please enter adress

*Telephone:

Please enter telephone

*HOW ACQUAINTED:

Please enter how acquainted

*YEARS ACQUAINTED:

Please enter year acquainted

*Name:

Please enter name

*ADDRESS:

Please enter adress

*Telephone:

Please enter telephone

*HOW ACQUAINTED:

Please enter how acquainted

*YEARS ACQUAINTED:

Please enter years acquainted

Additional Information

Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

ATTACH A RESUME

Acknowledgement

Please check If you are aware am aware that any omissions, falsifications, misstatements, or misrepresentations in this application may disqualify me for employment consideration and, if I am hired, may be grounds for termination at a later date. I understand that any information I give may be investigated as allowed by the law. I consent to the release of information about my ability, employment history, and fitness for employment by employers, schools, law enforcement agencies, and other individuals and organizations to investigators, personnel staff, and other authorized employees of The Vintner Group for employment purposes. This consent shall continue to be effective during my employment if I am hired. I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith.