Heb Employment Application - DOC

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Heb Employment Application - DOC Powered By Docstoc
					                                                    MANUFACTURING COMPANY
                                                                      P.O. Box 901
                                 Sheboygan Falls, Wisconsin 53085-0901                   •     Phone 920-467-4621

                                                    EMPLOYMENT APPLICATION
                                                        “AN EQUAL OPPORTUNITY EMPLOYER”



Name                                                                                                Telephone No.
                Last                        First                     Middle Initial

Present Address
                                      No.                         Street               City                            State                    Zip Code

How long at above address?                                                                          Social Security No.

Are there other names under which you have worked or attended school                          Yes        No

If Yes, please list for reference checking purposes

Are you legally able to work in the U.S.?            Yes         No

Have you ever been convicted of a felony?            Yes         No

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

Are you under 18 years of age?         Yes           No       If Yes, please indicate the date of birth

Do you have relatives employed by Bemis?             Yes         No

If Yes, give names and relationship


                                                                                               PLACE AN “X” NEXT TO THE LAST GRADE                 DID YOU
                          NAMES AND ADDRESSES OF SCHOOLS                                                    COMPLETED                             GRADUATE?
 LAST ELEMENTARY SCHOOL                                                                                      1     2         3      4
                                                                                                             5     6         7      8

                                                                                                         9        10         11     12

 JR. COLLEGE, COLLEGE OR UNIVERSITY                        MAJOR SUBJECTS                       YRS.                         DEGREES              GRADUATED


                                                             EMPLOYMENT DESIRED
                                                                                                          Shift        1st     would you work    Full time
Position(s) applied for                                                                              Preferred         2nd                       Part time weekends
                                                                                                                       3rd                       Part time weekday

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

                                                                                                                                                     8/10/09 MW
                                                                          EMPLOYMENT RECORD

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

                                                                       EMPLOYMENT REFERENCES

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

                                                                APPLICANT PERSONAL COMMENTS

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.

                                                                                                                                                                          8/10/09 MW

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