The Piggly Wiggly Application Form is an essential document for anyone looking to apply for employment with Piggly Wiggly Alabama Distributing Company Inc. It demands detailed personal and employment history, underscores the legal implications of false representation, and mentions the compliance with various anti-discrimination laws. Individuals interested in pursuing a career with this company need to meticulously complete and submit this form, ensuring all information provided is accurate and up-to-date. If you're ready to take the next step in your career with Piggly Wiggly, click the button below to fill out your application form.
Download PDFFilled with crucial details for both prospective employees and the Piggly Wiggly Alabama Distributing Company, Inc., the Driver’s Application for Employment is a comprehensive document designed for those seeking driving positions within the company. Located at 2400 J. Terrell Wooten Drive, in Bessemer, AL, the form covers a wide range of necessary information starting from basic personal data to detailed employment history, specifically over the previous ten years for those who have driven commercially. Applicants are required to provide information about prior convictions, if any, ensuring transparency and adherence to legal standards. The form also aligns with anti-discrimination laws, such as the Civil Rights Act of 1964 and Public Law 90-202, which prohibit employment discrimination based on race, color, religion, national origin, or age, highlighting the company's commitment to equal opportunity employment. Furthermore, it asks for a detailed account of any traffic accidents or convictions, alongside a section dedicated to the applicant’s driving experience and qualifications, ensuring that only the most qualified and reliable candidates are considered for driving roles. Lastly, it touches upon the educational background of the applicant and includes a segment for representing any periods of unemployment, rounding off the thorough vetting process designed to ensure safety, compliance, and the highest standards of employment practices within Piggly Wiggly.
| Question | Answer |
|---|---|
| Form Name | Piggly Wiggly Printable Application |
| Form Length | 4 pages |
| Fillable? | Yes |
| Fillable fields | 177 |
| Avg. time to fill out | 36 min 28 sec |
| Other names | piggly wiggly application online, piggly wiggly application pdf, online forms relief package, piggly wiggly apply |
DRIVER’S APPLICATION FOR EMPLOYMENT
PIGGLY WIGGLY ALABAMA DISTRIBUTING COMPANY INC.
2400 J. Terrell Wooten Drive, Bessemer, AL 35020
APPLICATION FOR EMPLOYMENT
PERSONAL (PLEASE PRINT PLAINLY)
“ MISREPRESENTATIONS AS TO PRE EXISTING PHYSICAL OR MENTAL CONDITIONS MAY VOID
YOU WORKMEN’S COMPENSATION ”
The Civil Rights act of 1964 prohibits discrimination in employment because of race, color, religion or national origin. Public Law prohibits discrimination of age. The laws of some states prohibit some or all of the above mentioned types of discrimination.
Date of Application ______________________
Social Security No .
List your addresses of residency for the past 3 years.
Date of Birth ______/_________/________
_______________________________________________ Phone (______)
________________________________________________________________________ How Long? _____________________
State & Zip Code
____________________________________________________________ How Long? ____________________
State & Zip Code
____________________________________________________________ How Long? ____________________
State & Zip Code
Have you worked for this company before? ________________ Dates: From ____________ To ______________
Position ______________________ Reason for leaving ________________________________________________
Are you currently employed? __________ If not, how long since leaving last employment __________________
Have you ever been convicted of a crime, excluding misdemeanors and summary offenses? ________________
If yes, Describe in full ___________________________________________________________________________
Who referred You? _______________________________ Can you provide proof of age? ___________________
Do you want to work fulltime or part time? ________ Specify days and hours if part time__________________
If hired, on what date will you be available to start work? ____________________________________________
Date of last DOT Physical Examination ___________________
Person to be notified in case of accident or emergency
Phone Number __________________________________________________________________________________________________
Please fax completed copy to:
All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code.
Applicants to drive a commercial motor vehicle in intrastate or interstate commerce shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle. (Note: List employers in reverse order starting with the most recent. Add another sheet as necessary.)
Reason For Leaving
Were you subject to the FMCSRs while employed?
Was your Job designated as a function in any mode subject to the Drug and Alcohol testing requirements of 49 CFR part 40?
Reason For Leaving
Were you subject to the FMCSRs while employed?
Was your Job designated as a function in any mode subject to the Drug and Alcohol testing requirements of 49 CFR part 40?
Reason For Leaving
Were you subject to the FMCSRs while employed?
Was your Job designated as a function in any mode subject to the Drug and Alcohol testing requirements of 49 CFR part 40?
Reason For Leaving
Were you subject to the FMCSRs while employed?
Was your Job designated as a function in any mode subject to the Drug and Alcohol testing requirements of 49 CFR part 40?
May we contact the employers listed above? If, not, indicate below which one(s) you do not wish us to contact.
Please fax completed copy to:
ACCIDENT RECORD FOR PAST 3 YEARS OR MORE (ATTACH SHEET IF MORE SPACE IS NEEDED). IF NONE, WRITE NONE.
Nature Of Accident
TRAFFIC CONVICTIONS AND FORTEITURES FOR THE PAST 3YEARS (OTHER THAN PARKING VIOLATIONS) IF NONE, WRITE NONE
(ATTACH SHEET IF MORE SPACE IS NEEDED)
EXPERIENCE AND QUALIFICATIONS – DRIVER
List all driver licenses or permits held in the past 3 years.
A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?
B. Has any license, permit or privilege ever been suspended or revoked?
If the answer to either A or B is Yes, GIVE DETAILS ______________________________________________________________________________________________
Driving Experience Check Yes or No
Class of Equipment
Circle Type Of Equipment
Approx. No. of Miles
(Van, Tank, Flat, Dump, Refer)
(Van, Tank, Flat, Dump, Refer)
Tractor – Two Trailers
(Van, Tank, Flat, Dump, Refer)
Tractor – Three Trailers
(Van, Tank, Flat, Dump, Refer)
List States operated in for last five years __________________________________________________________________________________________________________
Circle Highest Grade Completed
1 2 3 4 5 6 7 8 High School
1 2 3 4 College
Last School Attended _____________________________________________________________________________________________
Show special courses or training that will help you as a Driver: ________________________________________________________________________________________
Which safe driving awards do you hold and from whom? _____________________________________________________________________________________________
Please fax completed copy to:
You must account for all periods of unemployment in the last five (5) years.
List all lost time in excess of 30 days.
To be read and signed by applicant
I understand that this is an application and not a contract or a unilateral offer to enter into a contract of any kind betwee n the undersigned and the employer. The use of this application form does not indicate that there are any positions open and does not in any way obligate this employer.
I understand that employment is conditional upon and I authorize you to make such investigations and inquire of my personal, employment, financial and other legally related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools or persons from any and all liabilities and responding to inquires in connection with my application.
I hereby certified that all of the information I have given on this application is true and complete and that there are no false statements or omissions contained in my response to the questions in this application. I understand that any false information or omissions whether made or omitted intentionally or written and later discovered, may be cause for refusal to hire me or for immediate dismissal without further notice.
This application is current for only [60] days. At the conclusion of this time, if I have not heard from the Employer an d still wish to be considered for employment, it will be necessary for me to fill out a new application.
I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will b e contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:
∙ Review information provided by previous employers.
∙ Have errors in the information corrected by previous employers and for those previous employers to the corrected information to the prospective employer; and
∙ Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
Signature ______________________________________________________ Date _______________________________________
Please fax completed copy to:
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End by reviewing the following sections and filling them out accordingly: Head, on, Rear, End, Upset, Etc MaterialS, pills Last, Accident Next, Previous Next, Previous Location, Date, Charge, Penalty, ATTACH, SHEET, IF, MORE, SPACE, IS, NEEDED EXPERIENCE, AND, QUALIFICATIONS, DRIVER Yes, State, Type, and Driver.
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