FILL OUT, PRINT ,SIGN and take to Sally Lombardi 100 Distribution Drive, Sparks, NV 89441

APPLICATION FOR EMPLOYMENT

We are an equal opportunity employer, dedicated to a policy of non-discrimination in
employment on any basis including race, color, age, sex, religion, handicap or national origin.
__________________________________________________________________________________

PERSONAL INFORMATION

Date: , Social Security #:

Last Name: First Name: Middle Initial:

Street Address: City:

State: Zip Code:

Phone #:

Can you meet the 21-year age requirement to work in the alcohol beverage industry ? Yes No

___________________________________________________________________________________

EMPLOYMENT DESIRED

Position Desired: Date You Can Start: ,

Salary Desired:

Are you employed now? Yes No

If so, may we inquire with your present employer? Yes No

Ever applied to this company before? Yes No

If so, where? If so, when?

Are you a U.S. Citizen or otherwise authorized to work in the U.S. without restriction? Yes No

Have you ever been discharged from any position? Yes No

If Yes, please explain

Have you ever been convicted of a felony? Yes No

If Yes, please explain

Referred By:

___________________________________________________________________________________

EDUCATION

	Check Last Year Completed	Did You Graduate ?
Grammar School
High School	1 2 3 4	Yes No
College	1 2 3 4	Yes No
Trade, Business, Corresepondence School	1 2 3 4	Yes No

Were you in the U.S. Armed Forces? Yes No

Dates of Duty? from

__________________________________________________________________________________

GENERAL

Subjects of Special Study or Research Work:

Job Related Skills ( Typing, Driver's License, etc.):

Activities other than religious ( Athletic, civic, etc.):
____________________________________________________________________________________

FORMER EMPLOYERS

(List below your last four employers, starting with the most present one first)

Date	Name & Address of Employer	Salary (Upon Leaving)	Position	Reason For Leaving

From: To:	1.
From: To:	2.
From: To:	3.
From: To:	4.

Please indicate, by number, the employer(s) you DO NOT wish to be contacted 1 2 3 4

_______________________________________________________________________________________

REFERENCES

(List below three persons not related to you, whom you have known at least one year)

Name	Address	Position	Years Acquainted

If the company hires you, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. Candidates unable to comply with these requirements will not be considered for employment.
_____________________________________________________________________________________

AUTHORIZATION

1.Initials	I certify that the facts contained in this application ( and accompanying resume, if any ) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the Company.

2.Initials	I understand that any employment is conditioned on a background check. I authorize the Company to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the Company, without giving me prior notice of such disclosure. In addition, I release the Company, any former employers and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure.

3.Initials	I understand and agree that nothing contained in the application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless made in writting.

4.Initials	If I am offered employment I agree to submit to a medical examination and drug tests before starting work. If employed, I also agree to submit to a medical examination or drug test at any time deemed appropriate by the Company and as permitted by law. I consent to such examinations and tests, and I request that the examing doctor disclose to the Company the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment will be that I abide by the Company's Drug and Alcohol Policy.

5.Initials	I understand that filling out this form does not indicate there is a position open and does not obligate the Company to hire. If hired, I agree to abide by all Company work rules, policies and procedures. The Company retains the right to revise its policies or procedures, in whole or in part, at any time.

Signature of Applicant	Date

EMPLOYMENT APPLICATION

DeLuca Liquor & Wine, Coors Of Las Vegas, Nevada Wine Agents and Silver State Liquor & Wine
does not discriminate beacuse of Race, Religion, Color, Age, Sex, Disability, Veteran Status,
or any other reason prohibited by law.

You will be required to present documents to verify your employment eligibility as a condition of employment.
Certain job classifications will be required to take a medical examination after the offer is made. Employment for such positions is conditional upon meeting the bona fide occupational qualifications of the position.
You will be required to take a drug test as a condition of employment.
You will be required to complete a patent agreement and disclosure agreement as a condition of employment.
Security clearence is a necessary condition of continued employment for some conditions with our companies.

Name	Position Applied For

TO BE CONSIDERED FOR EMPLOYMENT, YOU MUST READ, INITIAL, SIGN AND DATE THE
ACKKNOWLEDGEMENT SECTION OF THIS APPLICATION.

ACKNOWLEDGEMENTS

1.Initials:	I understand that DeLuca Liquor & Wine, Coors Of Las Vegas, Nevada Wine Agents or Silver State Liquor & Wine will rely on the accuracy and completeness of my statements and that any misstatements, omissions or false statments made by me may be cause for dismissal.

2.Initials:	I understand that as a part of the employment procedure, an inquiry may be made which will provide applicable information concerning my employment history, performance and character.

3.Initials:	In making this application for employment, I hereby give DeLuca Liquor & Wine, Coors Of Las Vegas, Nevada Wine Agents or Silver State Liquor & Wine, the right to make a thorough investigation concerning my employment history, performance and character including the right to make a consumer report and an investigate consumer report that will include information on my character, general reputation, personal characteristics, and mode of Living. This information may be obtained through personal interviews with third parties, such as past employers, Business associates, financial sources, neighbors, friends, associates or others with whom I am aquainted, and by obtaining transcripts, records, or other documents. I also understand that if an investigative consumer report is requested, I have a right to make a written request for a disclosure concerning the nature and scope of such investigate consumer report, and the right to receive such disclosure.

4.Initials:	I hereby release DeLuca Liquor & Wine, Coors Of Las Vegas, Nevada Wine Agents or Silver State Liquor & Wine for any liability for any damage whatsoever as result of any investigation, inquiry, consumer report or investigate consumer report made by DeLuca Liquor & Wine, Coors Of Las Vegas, Nevada Wine Agents or Silver State Liquor & Wine, its representatives and designees. I also authorize any person, association, firm, company, law enforcement agency, or personnel office to furnish characteristics, my mode of living, my education, my previous employment, my performance, my credit, my references, any criminal conviction records, any motor vehicle record, and any other record, and I release them from any liability for any damage whatsoever for issuing such information.

5.Initials:	If any employment relationship is established, I understand that I retain the right to terminate my employment at any time and that DeLuca Liquor & Wine, Coors Of Las Vegas, Nevada Wine Agents or Silver State Liquor & Wine retain similar rights.

6.Initials:	I acknowledge my understanding that statements, which may be contained in policies, practices, handbooks, and other company material, do not create any guarantee of employment. Any promises to the contrary will only be relied on by me if they are in writing and signed by an authorized company official.

7.Initials:	I understand and agree that may berequired to take a physical examination, hair, blood or urine test at company expense at any time to determine if I am drug free and physically fit for the job I am responsible to perform. I understand that my refusal to submit to such examination and/or testing may result in termination and I waive all claims for damages resulting from such examination or testing. I understand that the company has the right to modify, amend or terminate policies, practices, benefit plans and other company programs within the limits and requirements of law.

8.Initials:	I agree that any person authorized by management can at any time request that I submit to a search of my person, purse and any packages in my possession or any locker that may be assigned to me. I understand that my refusal to submit to such a search may result in termination and I waive all claims for damages resulting from such search or termination.

Name:
Signature:
Position Applied For :
Date:

Equal Opportunity Form

Applicant Information

Last Name: First Name: Middle Initial:

Street Address: City:

State: Zip Code:

Phone #: Social Security #: Position applied for:

Voluntary Information

This information is being requested in accordance with federal regulations. The information is voluntary and will not be used when considering you for employment with our company.

Racial or Ethnic Group

	American Indian/Alaskan	Asian/Pacific Islander	Black/African American
	Hispanic/Latino	White/Caucasian	Other

Gender
	Female	Male

Military Service
	Pre-Vietnam Era	Vietnam Era
	Post-Vietnam Era	Disabled Veteran

How did you hear about this position?
	Newspaper	Company Employee	Professional Publication
	Job Fair	Placement Office	Web Site
	Other