OnlineApplication Northern Bottling Company’s Pre-Employment AffidavitOnline ApplicationEqual Opportunity EmployerNorthern Bottling Company is an equal employment employer. We pledge continued positive action to insure equal opportunity for all employees regardless of race, color, religion, natural origin, sex, age, or disability. It is our policy to provide employent opportunities to qualified disabled individuals, and veterans. By my signature and initials placed below, I promise that the information provided in this employment application is true and complete. I understand that any false information or significant omission may disqualify me from further consideration for employment, and may be justification for my dismissal from employment if discovered at a later date. I authorize the investigation of all statements contained in this application (and accompanying resume, if any). I agree to notify the company within 24 hours (for pending applicants) or at the beginning of my first shift after an incident if I should be convicted of a felony, or any crime innvolving dishonesty or breach of trust, or for arrest of a moving violation or upon conviction of a moving violation or such violation which could have been charged as such during my period of employment, if hired.Initial(Required)External DisclosureI authorize any person, school, current employer (except as previously noted), past employer, and organizations named in this application form to provide the company with relevant information and opinion that may be useful to the company in making a hiring decision, and I release such persons and organizations from any legal liability in making such statements.Initial(Required)Physical ExaminationI give permission for a complete employment physical examination, including a drug screening exam and x-rays. I consent to the release to the company of any and all medical information, as may be deemed necessary by the company in judging my capability to do the work in which I am applying.Initial(Required)Driving RecordI give permission for a complete check of my driving record including any state where I presently have or have had a driver’s license or permit.Initial(Required)Have you ever been convicted of a crime, other than a civil traffic offense for which you could have been fined or sentenced to jail or prison even if the sentence was suspended or deferred.(Required) Yes NoHonesty & IntegrityI understand that if the company terminates my employment for dishonest, breach of trust, or any criminal acts the authorities may be notified and I may be criminally prosecuted. I also understand that, if hired, I may not hold other employment, nor engage in sales, investment or other activities that create a conflict of interest with my position.Initial(Required)Are you legally entitled to work in the U.S.?(Required) Yes NoAt Will EmploymentI understand that this aplication does not, by itself, create a contract of employment. I understand and agree that, if hired, my employment is for no definite period of time, and may, regardless of the date of payment of any wages or salary, be terminated at any time. This is “At Will Employment”. I understand that no person is authorized to change any of the terms identified in this employment affidavit. Any verification made as a result of this release will be made in a professional manner by the general manager or at his/her request. Verifications will normally be made prior to job offer, after job offer and prior employment during evaluation period. Special conditions may require verifications during employment.Signature(Required)Date(Required)Position DetailsPosition Applying For(Required)Where did you hear about this position?(Required)**NoneRadioNewspaperCurrent EmployeeOther (Please Specify)Please SpecifyFirst Name(Required)Middle Initial(Required)Last Name(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Primary Phone(Required)Secondary PhoneEmail(Required) Date You Can Start Work(Required) MM slash DD slash YYYY Will Accept(Required) Part-Time Full-time SeasonalAre you related to any current employee?(Required) Yes NoAre you able to perform the essential functions of the job you are applying for, with or without reasonable accommodation?(Required) Yes NoAvailability(Required) Sunday Monday Tuesday Wednesday Thursday Friday SaturdayUpload Resume (Please upload PDF file format – 2MB max)Max. file size: 2 MB.Do you have a valid drivers license?(Required) Yes NoDriver's License Number(Required)Driver's License Issuing State(Required)Driver's License ClassDo You have a High School Diploma?(Required) Yes NoDo You have a GED?(Required) Yes NoYear of Graduation (High School or GED)(Required)Name of School, City, StatePost High School Education (list most recent)Major/Course of StudyEarned DegreeGraduated? Yes NoYear of GraduationOccupational License, Certificate, or RegistrationNumberIssued ByExpiration DateAre you a U.S. Military Veteran? Yes NoDescribe volunteer work, community involvement, hobbies, or other qualifications or skills.Work Experience(List current or most recent first)Employer(Required)Phone NumberStart Date(Required)End DateHours Per Week(Required)Duties/Skills/Equipment and Software Used:Job TitleStreet Address/City/StateReason for LeavingMay We Contact This Employer? Yes NoLast Salary(Required)Last SupervisorConfirmationI certify the information contained in this application is true, correct, and complete. I understand that if I become employed, false statements reported on this application may be considered sufficient cause for dismissal.Applicant Signature(Required)Date(Required)CAPTCHASubmit Step 1One more step to complete your application. You must fill out our Predictive Index® Organization Survey. Without this your application will not be complete.EmailThis field is for validation purposes and should be left unchanged.