<p> MANUFACTURING COMPANY P.O. Box 901 Sheboygan Falls, Wisconsin 53085-0901 • Phone 920-467-4621</p><p>EMPLOYMENT APPLICATION</p><p>“AN EQUAL OPPORTUNITY EMPLOYER”</p><p>PERSONAL Date </p><p>Name Phone No. Last First Middle Initial Present Address No. Street City State Zip Code E-mail Address How long at above address? Social Security No. Are there other names under which you have worked or attended school? Yes No</p><p>If Yes, please list for reference checking purposes </p><p>Are you legally able to work in the U.S.? Yes No </p><p>Have you ever been convicted of a felony or misdemeanor? Yes No</p><p>If Yes, explain. (Give date and place of conviction.) *No applicant will be denied a position because of a past conviction which is not substantially related to the circumstances of the position sought.</p><p>Are you under 18 years of age? Yes No If Yes, please indicate the date of birth </p><p>Do you have relatives employed by Bemis? Yes No</p><p>If Yes, give names and relationship </p><p>EDUCATION</p><p>PLACE AN “X” NEXT TO THE LAST GRADE DID YOU NAMES AND ADDRESSES OF SCHOOLS COMPLETED GRADUATE? LAST HIGH SCHOOL 9 10 11 12 </p><p>YRS. DID YOU JR. COLLEGE, COLLEGE, OR UNIVERSITY MAJOR SUBJECTS COMPL’D DEGREES GRADUATE?</p><p>TECHNICAL OR VOCATIONAL SCHOOL</p><p>EMPLOYMENT DESIRED Shift Preferred: Would You Work: 1st Full time Position(s) applied for 2nd Part time weekends (Be specific) 3rd Part time weekday</p><p>IR1526 12/23/15 MW Summer Were you previously employed by Bemis? If Yes, when? </p><p>Have you ever applied for employment with Bemis? If Yes, when? </p><p>IR1526 12/23/15 MW EMPLOYMENT RECORD</p><p>EMPLOYED (Give Most Recent Month & Year Employer First) NAME OF SALARY EMPLOYER’S NAME AND LAST JOB DUTIES OR REASON FOR FROM TO ADDRESS PHONE NO. SUPERVISOR YOUR TITLE OR TASKS WAGE LEAVING</p><p>MILITARY RECORD</p><p>Branch RANK Years Served/Date of Discharge</p><p>EMPLOYMENT REFERENCES</p><p>List individuals familiar with your job qualifications (no personal friends or relatives).</p><p>NAME PHONE NO. OCCUPATION: </p><p>NAME PHONE NO. OCCUPATION </p><p>APPLICANT PERSONAL COMMENTS</p><p>State any additional information you feel may be helpful to us in considering your application or any education or training that would be beneficial to the job for which you are applying.</p><p>Please read carefully before signing.</p><p>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.</p><p>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.</p><p>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.</p><p>I understand that the Company requires the successful completion of a drug test as a condition of employment prior to start date. By submitting this Application for Employment, I hereby consent to this test at the Company’s discretion.</p><p>Signed by Applicant Date </p><p>Thank you for your interest in our Company.</p><p>APPLICATION VALID FOR 60 DAYS IR1526 12/23/15 MW</p>