Application for Employment WESTERN CONTAINER CORPORATION Please print all information. Information to submit the application is included on the final page. Western Container Corporation is an Equal Opportunity Employer. The Company does not discriminate in hiring, or any other term and condition of employment, based on race, age, color, religion, sex, national origin, age, disability, marital status, sexual preference or any other characteristic protected by law. This application, upon being fully completed and submitted to the Company, will be considered for employment purposes for 30 days. After this period of time, you will have to re-apply to be considered for employment. PERSONAL INFORMATION Last Name First Name Middle Current Address City State Zip Home Phone Number EMPLOYMENT INTERESTS List type of work you desire: Cell Phone Number Date available for work: Please write a brief summary of why you are suited to do this type of work at Western Container. What are your salary requirements? Shift Preference Day Evening Night Are you willing to be assigned to a night shift? Yes Do you have experience working a 12-hour shift? Yes GENERAL INFORMATION How did you hear about Western Container? Have you ever been employed by Western Container? Yes If yes, list dates and location: Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.) Yes Can you provide proof of your identity and legal authorization to work in the United States? Yes Are your school records or previous employment records under any name(s) other than the one you now use? Yes If yes, list the other names(s): Have you ever been discharged or asked to resign from any job? Yes If yes, please explain where, when, reasons, etc.: Have you ever been convicted of, or pleaded guilty or nolo contendere (no contest) to, or received unadjudicated probation for, a crime other than a minor traffic violation? (DUI is not a minor traffic violation.) NOTE TO ALL APPLICANTS: A Yes response will not necessarily disqualify an applicant from employment. Failure to answer this question accurately could result in denial of employment or, if hired, termination of employment. Yes If yes, please list the offense, where the offense occurred, the date of the offense and its disposition: Prepared By: Tammye Chaney Approved By: Director of HR Application Page 1 of 5
EDUCATION Please list education as completely as possible. Information will be verified. Number of Type of School Years Attended Name and location of school High School Graduated or GED obtained? (Yes or No) Field of Study College Other (please explain) EMPLOYMENT HISTORY List all jobs beginning with the most recent employment first. Account for the past 10 years, including full-time and part-time employment, self-employment, and military service, if any. Attach additional sheet if necessary. Complete this section even if you attached a resume. 1. Employer (Present or Most Recent) Street City, State, & Zip Phone Number If we contact your present employer, will such action jeopardize your position? Yes 2. 3. Prepared By: Tammye Chaney Approved By: Director of HR Application Page 2 of 5
4. 5. 6. ADDITIONAL INFORMATION: (You may use this space for any additional comments, considerations, references, skills, or information that may be helpful in reviewing your application. Examples of these could include Forklift Certification, electrical training, Team Leader for a project, etc. ) Prepared By: Tammye Chaney Approved By: Director of HR Application Page 3 of 5
PERSONAL REFERENCES: Please list two personal references who have knowledge of you personally. Please do not list relatives. Provide complete contact information. PROFESSIONAL REFERENCES: Please list two business references who have knowledge of your qualifications for the position for which you are applying. Please do not list relatives. Provide complete contact information. Position: Organization: Position: Organization: Any offers of employment are subject to verification of employment eligibility as required by the Immigration Reform and Control Act of 1986. Please read before signing: I hereby authorize the company to investigate all statements contained in this application and on my attachments. I certify that all statements made are true and complete to the best of my knowledge. I understand and agree than any falsification of the information on this form may, if I am employed, be considered grounds for immediate dismissal. I understand that as a condition of employment, I will be required to take and pass a drug and alcohol test prior to or during my employment. In this regard, any offer of employment is contingent on me successfully completing a drug/alcohol screening test consistent with the Company s policies. I understand and agree that, if I am hired, my employment may be terminated at any time with or without cause and with or without notice, for any lawful reason, at the option of the Company or me. I understand that the Company may obtain consumer reports, consumer credit reports and/or investigative consumer reports about me, including a search of criminal records and verification of my education and employment history, in connection with this application or during my employment, if hired. I have authorized or will be authorizing the obtaining of such reports. I hereby authorize all persons or businesses contacted by or on behalf of the company about me to disclose to the company any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. I also authorize the persons named herein as references to provide the company with any pertinent information they may have regarding me. In addition, I hereby fully release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigations or disclosures. I further understand that all disputes arising from or relating to my application for employment or my employment with the Company must be resolved in accordance with the Company s dispute resolution program, a copy of which will be provided upon being offered employment and which is available upon request. The dispute resolution program, which is binding on employees and the Company, requires arbitration for all disputes that are not otherwise resolved by agreement. I agree to resolve all disputes in accordance with this program and, if offered employment, I will execute a further acknowledgement of this agreement. SIGNATURE OF APPLICANT DATE Page 5 of this application is an instruction page. You only need to submit pages 1 through 4. Prepared By: Tammye Chaney Approved By: Director of HR Application Page 4 of 5
To inquire about open positions or submit a completed application, please use the contact information below for the specific location you are interested in. Once an application is submitted, additional information may be requested from you by that location. Western Container Corp - Big Spring wccjobsbs@coca-cola.com 1600 First Ave Big Spring, TX 79720 FAX 432-263-8075 Western Container Corp Houston wccjobshou@coca-cola.com 3801 Distribution Blvd Houston, TX 77018 FAX 713-691-2634 Western Container Corp Hattiesburg wccjobshat@coca-cola.com 110 W. L. Runnels Industrial Drive Hattiesburg, MS 39401 FAX 601-584-6601 Western Container Corp Tolleson wccjobsaz@coca-cola.com 9860 W Buckeye Tolleson, AZ 85353 FAX 623-907-5600 Western Container Corp Fife wccjobsfife@coca-cola.com 2205 70 th Avenue East Fife, WA 98424 FAX 253-896-1426 Western Container Corp Sugar Land wcchr@coca-cola.com 2150 Town Square Place, 4 th Floor Sugar Land, TX 77479 Prepared By: Tammye Chaney Approved By: Director of HR Application Page 5 of 5