Apply Now – Employment Application

This field is for validation purposes and should be left unchanged.

Applicant Information

Name(Required)

First Last

Day Phone Number(Required)

Evening Phone Number(Required)

Email(Required)

Are there ANY other names under which you have worked or attended school?(Required)

Yes

No

If yes, please list for reference checking purposes. This includes Maiden Name.(Required)

Are you legally authorized to work in the U.S.?(Required)

Yes

No

If hired, you will be required to provide proof of work authorization.

Are you at least 18 years old?(Required)

Yes

No

If not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work you are applying for and have obtained a valid work permit.

Have you ever been convicted of a crime or pleaded no contest for any offense or violation other than minor traffic violations?(Required)

Yes

No

If yes, explain:(Required)

1) nature of crime, 2) date of conviction and 3) state in which convicted. (Convictions are not an automatic bar to employment)

Do you have any pending criminal charges against you?(Required)

Yes

No

If yes, describe the:(Required)

1) nature of the charges, 2) date issued, and 3) county and state where issued.

Have you ever applied at this company before?(Required)

Yes

No

If yes, when?(Required)

Have you ever worked at this company before?(Required)

Yes

No

If yes, when?(Required)

Hiring Information

(please indicate job title from job posting)

What position are you applying for?(Required)

(please indicate job title from job posting)

Is it a full-time, part-time or temporary position?(Required)

Desired Salary:(Required)

When can you start?(Required)

Will you work overtime if required?(Required)

Yes

No

Are you able to perform the essential functions of the job you are applying?(Required)

Yes

No

(with or without restrictions and as per identified in the job posting)

How were you referred to the company:(Required)

Summarize any special training, skills, language, license and/or certifications that may assist you in performing the position for which you are applying for:(Required)

Education

High School Information

Name, Location (City and State)

Years Attended

Major Subjects

Diploma/Degree Received

College Information

Name, Location (City and State)

Years Attended

Major Subjects

Diploma/Degree Received

Graduate Information

Name, Location (City and State)

Years Attended

Major Subjects

Diploma/Degree Received

Other Education

Name, Location (City and State)

Years Attended

Major Subjects

Diploma/Degree Received

Training Courses

Confidentiality Agreement Disclosure

Have you signed a Secrecy/Confidentiality Agreement in favor of any previous employer?(Required)

Yes

No

If yes, give their names and addresses:(Required)

Is your acceptance of employment restricted in any way by virtue of any contract, agreement, promise or understanding previously entered or executed by you?(Required)

Yes

No

If yes, provide details:(Required)

DRIVER'S LICENSE INFORMATION

(Complete section only if applying for position that requires use of company vehicle)

Driver's License Number:

Issuing State:

Expiration Date:

Have you been convicted of a driving related offense?

Yes

No

If Yes, please explain:

Has your license been suspended or revoked in the last FIVE (5) years?

Yes

No

If Yes, please explain:

Employment History

(start with the most recent; use separate sheet if needed)
All references will be checked - unless you respond "no" to current employer.
All relevant boxes must be completed. Incomplete or "see resume" responses are not acceptable.

Employer 1

Name of Employer(Required)

Telephone(Required)

Address(Required)

Job Title(Required)

Immediate Supervisor(Required)

Employment Dates (month and year)(Required)

Description of Duties(Required)

Salary:(Required)

Reason for Leaving:(Required)

If currently employed, may we contact them as a reference?(Required)

Yes

No

Employer 2 (Optional)

Name of Employer 2

Telephone 2

Address 2

Job Title 2

Immediate Supervisor 2

Employment Dates (month and year) 2

Description of Duties 2

Salary 2:

Reason for Leaving 2:

If currently employed, may we contact them as a reference? (2)

Yes

No

Employer 3 (Optional)

Name of Employer 3

Telephone 3

Address 3

Job Title 3

Immediate Supervisor 3

Employment Dates (month and year) 3

Description of Duties 3

Salary 3:

Reason for Leaving 3:

If currently employed, may we contact them as a reference? (3)

Yes

No

Authorization + Release

I hereby certify that all the information provided in this application is true and correct and that I have not omitted any relevant facts or information. I understand that if I have misrepresented or omitted any facts or information that I am subject to cancellation of consideration for employment or dismissal from employment. I understand that in compliance with the Fair Credit Reporting Act, a routine investigation may be made concerning my character, general reputation, personal characteristics, and mode of living, and that I have the right to make a written request within a reasonable period of time pursuant to P.L. 91-508 for a summary disclosure of the natures and scope of the investigation.

I further understand that acceptance of this application by Lakeside Bottling Company and its affiliated or related companies, (collectively referred to hereafter as Company), is no guarantee of employment and that should I become employed, my employment will be at will, which means it is terminable by Lakeside Bottling Company or myself at any time for any or no reason.

If employed, I agree to abide by the policies, rules and procedures of the Company, and I further agree to keep confidential all trade secrets, inventions, discoveries, and other proprietary information that I become aware of during my employment.

I understand that any position at the Company may have physical activity including, but not limited to walking, climbing stairs and lifting. I certify that I have no physical limitation or disabilities that would prevent me from performing such duties and that I have not sustained any kind of back injury during the past five years.

I hereby authorize the company to investigate all statements, facts and representations contained in this application for employment.

I hereby authorize all of my previous employers to release any and all information concerning my prior employment to the Company, including but not limited to dates of employment, positions held, salary, performance reports and reasons for leaving their employ, and I release any employer from any claim or liability for providing such information to the Company.

I hereby authorize the Department of Motor Vehicles (DMV) to provide required information.

I hereby authorize any educational institution I have attended to release to the Company, any and all information concerning my attendance at the institution, including but not limited to, dates of attendance, degrees awarded, class ranking, grade transcripts, and disciplinary recourse, and I release any such educational institution from any claim or liability for providing such information to the Company.

I hereby authorize all persons identified or referred to in this application to release any and all information to the Company, that is relevant to the consideration of this application for employment, and I release all such persons from any claim or liability for providing such information to the Company.

I hereby authorize the use of photocopies of this Authorization and Release for acceptance by all persons and parties as an original.

I hereby certify that I have read the above statements and understand them.

Date(Required)

Employment Applicaton

Applicant Information

Hiring Information

Education

High School Information

College Information

Graduate Information

Other Education

Training Courses

Confidentiality Agreement Disclosure

DRIVER'S LICENSE INFORMATION

Employment History

Employer 1

Employer 2 (Optional)

Employer 3 (Optional)

Authorization + Release