Personal Information:

Name:	U.S. Citizen Yes or No: If no show status
Street Address:	Phone:    E-mail:
City:	State:       Zip Code:
Position for which you are applying:
Date available for work:	Are you employed now:
Have you ever worked for us before: if yes what dates:  What Position: indicate if different name
Current/Most Recent Employer :     May we contact current employer:   Name:  Address:    Position:   Supervisor:   Phone:   Dates Employed: From   To   Wage: Starting  Ending   Duties:  Reason For Leaving:
Next Most Recent Employer :  Name:  Address:    Position:   Supervisor:   Phone:   Dates Employed: From   To   Wage: Starting  Ending   Duties:  Reason For Leaving:
Next Most Recent Employer :  Name:  Address:    Position:   Supervisor:   Phone:   Dates Employed: From   To   Wage: Starting  Ending   Duties:  Reason For Leaving:
If you have served in the armed forces please complete the following:  Branch of Service: Discharge Date:  Discharge Type: Reserve Status:  Rank, assignments and special training:
Education School Name & Location Graduation Date Area of Study/GPA High School Other Education
Please summarize skills and abilities obtained from education, employment and other activities:
Have you ever been convicted of a felony or misdemeanor  yes or no:  If yes please explain:
Indicate all languages you speak, read, and/or write and indicate fair, good or fluent for each one.
To Be Read By The Applicant:     It is agreed and understood that any misrepresentations of information given in the completion of this application shall    be considered an act of dishonesty and can result in your being denied employment or terminated if already employed.     It is agreed and understood that American Carton & Polybag Inc. or it's agents may investigate my background to   ascertain any and all information of concern relating to my record, whether same of of record or not, and hereby release   companies and persons named herein from all liability for any damages on account of their furnishing such information.     It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91508, I have been told that this   investigation may include an Investigating Consumer Report, including information regarding my character, general   reputation, personal characteristics, and mode of living.     I also agree to furnish such additional information and complete such examinations as may be required to complete my   employment file     It is also agreed and understood that this application for employment in no way obligates American Carton & Polybag,   Inc. to employ the applicant, and that if I am hired, I will be required to successfully complete a probationary period for   employment, during which time I may be discharged without recourse.     I further certify that I have personally completed this application and that all of the entries contained within the   application, along with any accompanying documents, are true and complete to the best of my knowledge.     Submission of this form indicates your agreement with the above statements and typing your name in the field below   will be considered your signature and the date stamp of the submission will act as the signature date.