Pepsi Cola Bottling Company
Application for Employment

Name:
Address:
City: State: Zip: Phone: ( )- -
Email Address:
Desired Position:
Date Available: / / Years of Experience: Expected Salary:

Is any additional information relative to change of name, use of assumed name, or nickname necessary to enable a check on the information you are providing on this form?

If yes, please explain:

Can you, after employment, submit verification of your legal right to work in the United States?
Are you 18 years of age or older?

Who do we notify in case of an emergency during working hours?
Name:
Telephone Number:( )- -

 
All Drivers Licenses Held in Last 3 Years
State: License Number: Class: Expiration Date: / /
State: License Number: Class: Expiration Date: / /
State: License Number: Class: Expiration Date: / /
Driving Experience Record
Class of Equipment: Type of Equipment(Van,Tank,Flat,Etc.):
Dates: (From): / / (To): / / Approx. Number of Miles:
Class of Equipment: Type of Equipment(Van,Tank,Flat,Etc.):
Dates: (From): / / (To): / / Approx. Number of Miles:
Class of Equipment: Type of Equipment(Van,Tank,Flat,Etc.):
Dates: (From): / / (To): / / Approx. Number of Miles:
Accident Record for Past Three Years
Month/Year: / Type of Accident: Type of Equipment:
Death or Injuries: City or County: Night or Day:
Month/Year: / Type of Accident: Type of Equipment:
Death or Injuries: City or County: Night or Day:
Month/Year: / Type of Accident: Type of Equipment:
Death or Injuries: City or County: Night or Day:
Traffic Convictions and Forfeitures for Past Three Years
(Other than parking Violations)
Location: Date: / / Charge: Penalty:
Location: Date: / / Charge: Penalty:
Location: Date: / / Charge: Penalty:
Has your License been revoked in the last three years?
If yes, give statement of circumstances:
General Driving Record
To date I have driven trucks for years, covering approx. miles. The date of my last accident while driving a commercial vehicle was / / . Since that time, I have driven approx. accident free miles.
Safe Driving Awards
Date: / / Award: Presented By:
While Employed By: In recognition of:
Date: / / Award: Presented By:
While Employed By: In recognition of:
 
Warehouse, Delivery and Production. Jobs may require physical agility and heavy lifting. Do you have any physical condition which may limit your ability to perform the job applied for?

If yes, what can be done to accommodate your limitation?:
Have you any relatives employed by this company?

If yes, please give names and positions:
Have you ever worked for this company before?

If yes, Where?: When?: / /
Are you currently employed?:

If so, may we contact your present employer?:
Please list job related organizations, clubs, and other associations to which you belong. You may omit those which indicate your race, color, creed, national origin, ancestry, sex, or age.
Have you ever been convicted of a felony?
(such conviction will not necessarily disqualify you from the position applied)

If so, explain, giving date, state of conviction and present status:
Have you ever been convicted of a misdemeanor which resulted in imprisonment within the last two years?
(such conviction will not necessarily disqualify you from the position applied)

If so, explain, giving date, state of conviction and present status:
 
Education
Schools
Name of School
Address
Graduate or Degree?
Grade
High
College
Business or Technical
Other
If you served in the military, list any skills learned which you feel are relevany to the position you are applying for:
Personal References
(Other than Relatives)
Name
Address
Occupation
Years Acquainted
Previous Employment
(Give a complete record of all employment and reasons of unemployment during the past 10 years)
Employers Address Position Employed(to/from) Reason for leaving
/ - /
/ - /
/ - /
/ - /
/ - /
Additional comments:
 
Click here if you wish to review your application before submitting.
 
APPLICANT: READ BEFORE SUBMITTING THIS APPLICATION.

A) I authorize the employer, or his agents, to investigate my background, including any past criminal or civil record, to ascertain any and all information of concern to my record, whether same is of record or not, and release employers and persons named herein from all liability for any damages on account of his or her furnishing such information.

B) I understand that misrepresentation or omission of facts called for on this employment application will, if hired, result in discharge.

C) I understand that since any offer of employment has no specified term, my employment with the employer may be terminated at the will of either party without cause.

D) I certify that this applicatin is completed by me and that all entries on it and information on it are true and complete. Furthermore, I have read and understand all of the conditions upon which this offer of employment is made.