MANUFACTURING COMPANY

201 Industrial Court NW

Lenoir, North Carolina28645 • Phone 828-758-9494

EMPLOYMENT APPLICATION

“AN EQUAL OPPORTUNITY EMPLOYER”

Date

Name Telephone No.

LastFirstMiddle Initial

Present Address

No.StreetCityStateZip Code

How long at above address? Social Security No.

Are there other names under which you have worked or attended schoolYesNo

If Yes, please list for reference checking purposes

Are you legally able to work in the U.S.?YesNo

Have you ever been convicted of a felony?YesNo

If Yes, explain. (Give date and place of conviction.)

Are you 18 years of age or older?YesNo

Do you have relatives employed by Bemis?YesNo

If Yes, give names and relationship

NAMES AND ADDRESSES OF SCHOOLS / CHECK LAST GRADE COMPLETED / DID YOU GRADUATE?
LAST ELEMENTARY SCHOOL / 1 2 3 4
5 6 7 8
LASTHIGH SCHOOL / 9 10 11 12
JR. COLLEGE, COLLEGE OR UNIVERSITY / MAJOR SUBJECTS / YRS. COMPL’D / DEGREES / GRADUATED
TECHNICAL OR VOCATIONAL SCHOOL

Shift1stwould you workFull time

Position(s) applied for Preferred2ndPart time weekends

3rdPart time weekday

Were you previously employed by Bemis? If Yes, when?


EMPLOYED
Month & Year / (Give Most Recent Employer First)
EMPLOYER’S NAME AND ADDRESS / PHONE NO. / NAME OF LAST
SUPERVISOR / WHAT DID YOU DO? / SALARY OR
WAGE / REASON FOR
LEAVING
FROM / TO

List individuals familiar with your job qualifications (No personal friends or relatives).

NAME / PHONE NO. / NO. & STREET
OCCUPATION / CITY, STATE, ZIP CODE
NAME / PHONE NO. / NO. & STREET
OCCUPATION / CITY, STATE, ZIP CODE

State any additional information you feel may be helpful to us in considering your application, or any education or military training that would be beneficial to the job for which you are applying.

Please read carefully before signing.

All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am hired.

I authorize the Company to investigate my responses on this application and contact any current or former employers, any individuals familiar with my employment, educational background, or me. It is for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about my employment, educational background, or me. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to my employment, educational background, or me.

Regardless of whether or not I become employed by the Company, I recognize that this application is not and should not be considered a contract of employment. I understand that employment at the Company is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the Company’s, unless specifically provided otherwise in a written employment contract. I further understand that no Company employee or representative has the authority to enter into a contract regarding duration or terms and conditions of employment other than an officer or official of the Company, and then only by means of a signed, written document.

I understand that the Company requires the successful completion of a drug test as a condition of employment. By submitting this Application for Employment, I hereby consent to this test at the Company’s discretion.

Signed by Applicant Date

Thank you for your interest in our Company.

APPLICATION VALID FOR 60 DAYS

SE7750

8/19/09 MW