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Application Info > Education & Employment History > Reference > Resume > Voluntary Affirmative Action > EEO Statement

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Position
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LocationLa Crosse
PositionPart-Time Weekend Merchandiser -- Winona Area
Applications Due By07/12/2019
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LocationLa Crosse
PositionPart-Time Weekend Merchandiser - Prairie Du Chien Area
Applications Due By07/12/2019
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LocationLa Crosse
PositionClass A CDL Driver - Saturday's only
Applications Due By07/12/2019
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LocationLa Crosse
PositionPT Truck Washer
Applications Due By07/12/2019
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LocationLa Crosse
PositionFull Time Merchandiser - Richland Center and Tomah area
Applications Due By07/12/2019
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LocationRochester
PositionPart-Time Merchandiser
Applications Due By07/12/2019
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LocationRochester
PositionPart-Time Merchandiser - Red Wing
Applications Due By07/12/2019
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LocationLa Crosse
PositionWeekend Store Merchandiser (Part-Time)
Applications Due By07/12/2019
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LocationDecorah
PositionWeekend Merchandiser (Part-Time)- Decorah
Applications Due By07/12/2019
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LocationRochester
PositionFull-time Summer Employment- Casual Merchandiser
Applications Due By07/12/2019
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LocationDecorah
PositionFull Time Summer Employment - Utility Worker!
Applications Due By07/12/2019
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LocationRochester
PositionPart-Time Merchandiser - Austin/Albert Lea
Applications Due By07/12/2019
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LocationAll
PositionDirector of Human Resources
Applications Due By07/31/2019
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Submit General Application

employment application

Thank you for completing this application. We appreciate your interest in our company. We consider applicants for all positions without regard to race, color, creed, religion, sex, sexual orientation, age, national origin, ancestry, citizenship, disability, or status as a disabled veteran, recently separated veteran, armed forces service medal veteran or other protected veteran who served active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense (collectively, "covered veterans"), or other legally protected status, as required by law.

contact information

Position(s) Applied For
Other:
Location applying to:                
Last Name *
First Name *
Middle *
Address *
City *
State *
Zip *
Email *
Home Telephone Number *
Cell Telephone Number
Work Telephone Number


information

Best time to contact you at home is * :
State age if under 18.
Have you ever been employed with us before?
If Yes, when:
How did you learn about job?
Newspaper Ad
Online Posting
Employment Agency
Friend
Company website
Radio Ad
Employee
Other

Salary required: *
Available to work *:
)
(Please indicate dates available   through   )
Are you legally eligible for employment in the U.S.A.? *
(Proper proof of employment eligibility will be required at time of hire.)
Are you currently employed? *
Do you have relatives working for Pepsi-Cola? *
If you have relatives working for Pepsi-Cola, enter their names here: *
Can you work overtime if job requires? *
Can you travel (if the job requires it)? *
Do you have a valid drivers license (if the job requires it)? *
Do you have a valid CDL (if the job requires it)? *


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education

School
Name & Location of School
No. Of Years Completed
Course of Study
Degree or Diploma
SchoolHigh School
Name & Location of School
No. Of Years Completed
Course of Study
Degree or Diploma
SchoolBusiness/Trade/Technical
Name & Location of School
No. Of Years Completed
Course of Study
Degree or Diploma
SchoolCollege
Name & Location of School
No. Of Years Completed
Course of Study
Degree or Diploma
SchoolGraduate School
Name & Location of School
No. Of Years Completed
Course of Study
Degree or Diploma

Employment

Please give accurate, complete full-time and part-time employment record. Start with your present or most recent employer. NOTE: Applicants for driving positions need to list employment history for the past 10 years.

Company Name
Address
Name of Supervisor
State Job Title and Description of Your Work
Telephone
Employed From
To
Hourly Pay Starting
Last
Reason for leaving
1
Company Name
Address
Name of Supervisor
State Job Title and Description of Your Work
Telephone
Employed From
To
Hourly Pay Starting
Last
Reason for leaving
2
Company Name
Address
Name of Supervisor
State Job Title and Description of Your Work
Telephone
Employed From
To
Hourly Pay Starting
Last
Reason for leaving
3
Company Name
Address
Name of Supervisor
State Job Title and Description of Your Work
Telephone
Employed From
To
Hourly Pay Starting
Last
Reason for leaving
4
We may contact the employers listed above unless you indicate those you do not want us to contact.
DO NOT CONTACT: Employer Number(s)
Reason
Reason


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references

1
Name
Telephone
Address

2
Name
Telephone
Address

3
Name
Telephone
Address


other qualifications

Summarize special job related skills and qualifications acquired from employment or other experience.

specialized skills (check skills/equipment operated)

Computer Skills (List Programs In Which Proficient)
Forklift/Pallet Jack

Other Machinery You Operate or Skills (Please List)

additional information

Membership(s) in professional and civic organizations, special accomplishments, awards, etc., or any other information you feel would be beneficial for us to know.
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Attach Resume

If you have a resume, you may attach it to your application below.
(This is optional and will not affect our decision of hire)

Maximum file size accepted: 2.00MB
File formats accepted:
  • Microsoft Word (doc, docx, dot)
  • Adobe Acrobat Portable Document Format (pdf)
  • Text (txt)
  • OpenDocument (odt)

If you would like to replace the resume that you've uploaded.
Click on the browse/choose file button and choose another file to upload.


Attach Resume Before Continuing Continue

Voluntary Affirmative Action Information

The company is a federal government contractor subject to Executive Order 11246, Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), and Section 503 of the Rehabilitation Act of 1973. The laws require the Company to take affirmative action to employ and advance in employment women, minorities, protected veterans and disabled individuals.
To comply with federal government affirmative action program record keeping and reporting requirements, we ask that you complete this data survey, which allows us to measure the effectiveness of the outreach and positive recruitment efforts we undertake. Your cooperation is appreciated. Providing this information is voluntary. Failure to provide it will not subject you to any negative action. Information provided will be kept confidential in accordance with applicable regulations.
Name
Voluntary Self Identification of Sex:
Male Female Decline to Identify
Voluntary Self Identification of race:
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or Origin, regardless of race.
White: A person having origins in any of the peoples of Europe, the Middle East, or North Africa.
Black or African American: A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaiian, Guam, Samoa, or other Pacific Islands.
Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
American Indian or Alaska Native: A person having origins in any of the original peoples of North or South America (including Central America), and who maintain tribal affiliations or community attachment.
Two or More Races: All persons who identify with more than one of the races of White, Black or African American, Native Hawaiian or other Pacific Islander, Asian, or American Indian or Alaska Native.
Decline to Identify
Voluntary Self Identification of Protected Veteran
As indicated above, your submission of this information is voluntary, the information will be kept confidential and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended (VEVRAA).
I am one or more of the classifications of protected veteran (disabled veteran; recently separated veteran; active duty wartime or campaign badge veteran; and Armed Forces service medal veteran) listed below
I am not a protected veteran
I decline to identify
Protected Veterans Definitions:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on the active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Voluntary Self Identification of Disability
Why are you being asked to complete this section of the form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities under Section 503 of the Rehabilitation Act of 1973, as amended. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. Any answer you give will be kept private and will not be used against you in any way.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include but are not limited to:

Blindness
Major Depression
Diabetes
Cancer
HIV/AIDS
Intellectual disability (previously called mental retardation)
Autism
Obsessive Compulsive Disorder
Schizophrenia
Bipolar disorder
Epilepsy
Impairments requiring the use of a wheelchair
Post-traumatic stress disorder
Missing Limbs or partially missing limbs
Deafness
Multiple Sclerosis (MS)
Muscular Dystrophy
Cerebral palsy

Yes, I have a disability (or previously had a disability) No, I don't have a disability I don't wish to answer

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job. Examples of reasonable accommodations include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

For more information about this form or the equal employment obligations of federal contractors, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp


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Employment-EEO Statement and Online Application Process

It is the policy of the Company to comply with all applicable federal, state and local laws and not discriminate against or harass any employee or applicant for employment because of race, color, religion, national origin, sex, sexual orientation, disability, protected veteran status, age, pregnancy, genetic testing or information, local human rights commission activity, gender identity, and all other federal, state, and local protected classes required by law.The Company will take affirmative action to ensure that all employment practices are free of such discrimination.Such employment practices include, but are not limited to, the following: hiring, promotion, demotion, transfer, recruitment or recruitment advertising, layoff, disciplinary action, termination, rates of pay or other forms of compensation, and selection for training.

To complete our online application process you will be asked to provide information which may include your place of residence, background and work history.This information will be used to determine your experience as it pertains to that position to which you have applied.You will not be considered an applicant until your application is complete and electronically submitted.The information you provide is subject to verification.You agree to allow the Company to process the information to determine your qualifications for the job.Providing fraudulent or misleading information will constitute grounds for disqualification for the job.We ask that you voluntarily provide the information requested during the application process, which may include, but is not limited to, gender, ethnic or racial background information and may constitute sensitive personal data.The Company is required to ask for this type of information in order to comply with its equal opportunity legal requirements.Refusal to provide this information will have no bearing on your application and will not subject you to any adverse treatment.

By completing the job application, you voluntarily agree that the Company may provide your application information to any third party we consider relevant solely for the purpose of assessing your qualifications for the job. Job application information may also be shared with the Company's subsidiary and affiliated companies for employment considerations only.

The Company is committed to providing accessibility to employment opportunities forindividuals with disabilities.If you require reasonable accommodations in the application or interview process; or have any other questions regarding the online application process, please call the Human Resources Department.

I Accept

Thank you for applying for the following position(s)
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Position

Your application will expire in 45 days.

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