This application is considered current for sixty (60) days only.

EMPLOYMENT APPLICATION
TEMPUR-PEDIC and its subsidiary companies will provide equal employment opportunities to all applicants without regard to an applicants race, color, religion, sex, gender, genetic information, national origin, age, veteran status, disability, or any other status protected by federal or state law. TEMPUR-PEDIC will provide reasonable accommodations to allow an applicant to participate in the hiring process (e.g., accommodations for a test or job interview) if so requested. When completing this application, you may exclude information that would disclose or otherwise reference your race, religion, age, sex, genetic, veteran status, disability, or any other status protected by federal or state law. This application is considered current for sixty (60) days only. At the end of this period, if you are still interested in employment, it will be necessary for you to reapply by completing a new application. THIS APPLICATION DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR DOES IT GUARANTEE EMPLOYMENT WITH TEMPUR-PEDIC. PLEASE PRINTUSE INKCOMPLETE ALL SECTIONSAND ATTACH A RESUME. Todays Date: GENERAL INFORMATION Last Name First Name Middle Name Home Address Mailing Address E-Mail Address City City State State Zip Code Zip Code Mobile Phone/Pager Home Telephone No. Business Telephone No.

All offers of employment are conditioned upon your ability to provide evidence of your right to be legally employed in the U.S. Are you currently eligible to work in the U.S., and authorized to work for this YES NO Company on an ongoing indefinite basis? Will you now or in the future require sponsorship by this Company to attain or maintain your employment eligibility? JOB INFORMATION Salary Desired: Can you travel, if the job requires it? YES Are you willing to work NO overtime, if required? Have you previously been employed by TEMPUR-PEDIC or any TEMPUR-PEDIC subsidiary or other related Company? If YES, please identify the company, your dates of employment, the position held, and the reason for leaving. YES NO YES NO YES NO

Have you previously applied for employment with TEMPUR-PEDIC or any TEMPUR-PEDIC subsidiary or predecessor? Do you have any relatives or friends that are employed with TEMPUR-PEDIC or any TEMPURPEDIC subsidiaries or predecessors?

YES NO YES NO

If YES, please provide name(s), relationship(s), and work location(s).

Are you currently subject to a non-compete or employment agreement with another employer?

YES NO

**A Note About Various State Laws** State law applies to you as an applicant if: (a) you are applying to an TEMPUR-PEDIC location within that state OR (b) you are currently residing within that state. CRIMINAL BACKGROUND INFORMATION In responding to the questions below, AK, AR, CA, CT, DE, IL, IN, KS, KY, LA, MA, MD, ME, MO, MI, MN, MS, NC, NH, NV, NJ, OH, OK, RI, VA, and WA applicants are not required to disclose the existence of any conviction which has been annulled, erased, sealed, expunged, or otherwise eradicated by state or court order. If your criminal records have been erased or expunged in accordance with state or federal law, you are deemed to have never been arrested with respect to those proceedings. Please mark appropriately. While a criminal conviction is not an automatic or absolute bar to employment, and while convictions will be considered based on the time and nature of the offense and as related to jobs applied for, applicants should answer the following questions unless prohibited by applicable state law. Have you ever been convicted of a crime? YES NO Currently reside in or applying for a job in MA; Philadelphia, PA; or HI If YES, please describe the circumstances of your conviction, including the date, nature, place of the offense, and disposition of the case.

EMPLOYMENT HISTORY Please provide a complete employment history listing all positions held for the last 10 years, starting with the most recent employer. Please account for any periods of unemployment at the end of this section. Employer #1 (Present or Most Recent Employer):

Address

City

State

Zip Code

Telephone

Position Employed from: ________(month) __________(year) To: _______(month) ________(year)

Supervisors Name Base Salary Starting: $______________

Supervisors Title Ending or Current Salary: $____________ Base Pay Hourly Rate: $__________________ Reason for leaving:

Base Pay/Hourly Rate: $______________ List any other compensation (bonus, commissions, draw, etc.).

When distributed (annually, quarterly, monthly)? May we contact this employer? Responsibilities: YES NO If NO, please explain.

Employer #2: Address City State Zip Code Telephone

Position

Supervisors Name

Supervisors Title

Employed from: ________(month) __________(year)

To: _______(month) ________(year)

Base Salary Starting: $______________ Base Pay/Hourly Rate: $______________

Ending or Current Salary: $____________ Base Pay Hourly Rate: $__________________

Reason for leaving:

List any other compensation (bonus, commissions, draw, etc.).

When distributed (annually, quarterly, monthly)?

May we contact this employer?

YES NO

If NO, please explain.

Responsibilities:

Employer #3: Address Position Employed from: ________(month) __________(year) To: _______(month) ________(year) City State Supervisors Name Base Salary Starting: $______________ Base Pay/Hourly Rate: $______________ List any other compensation (bonus, commissions, draw, etc.). Zip Code Supervisors Title Ending or Current Salary: $____________ Base Pay Hourly Rate: $__________________ Reason for leaving: Telephone

When distributed (annually, quarterly, monthly)? May we contact this employer? YES NO If NO, please explain.

Responsibilities:

Branch: Rank at Discharge: If other than honorable, explain:

MILITARY SERVICE Attach DD214 if applicable Length of Service: Type of Discharge:

Type of School: High School College Graduate School Other

EDUCATION Diploma/Degree Type: Name of School and (G.E.D., H.S., B.A., etc.) City/State:

Major Subject/Course:

If currently attending school, what are the days and times of your scheduled classes?

HOW WERE YOU REFERRED TO TEMPUR-PEDIC? Employee State or Local Agency Name:____________________________________ Name:____________________________________ School College name:___________________________________________________________________________ Employment Agency Name of Company:_________________________ Name of Contact:___________________________ Contact Phone:_____________________________ Internet Newspaper/Publication

Walk-In

Other____________________________________

REFERENCES In addition to the supervisors listed in the employment history section above, list three (3) professional references who can comment on your work performance. If not applicable, list three (3) personal references who are not related to you. Name/Relationship Address Occupation Telephone Number Length of Time Known Company/Job Title ________________________________

________________________________

________________________________

APPLICANT PLEASE READ AND SIGN I certify that the answers given to the questions and the statements made (including statements on the attached resume, and inserted forms, if any) on this application and in the hiring process are true. I understand that a false statement, a false answer, an omission, or a misleading statement may result in a decision not to hire me, the withdrawal of any offer of employment, or the termination of my employment with TEMPUR-PEDIC regardless of when such false, misleading, or erroneous information is discovered. I understand that if hired, unless I am employed under a specific written contract or collective bargaining agreement, my employment with TEMPUR-PEDIC will be "at will" and that my employment may be terminated at any time with or without cause and with or without notice. I understand that no representative of the Company has any authority to make any assurances, representations or promises contrary to the "at-will" nature of my employment unless it is in writing signed by an authorized officer of TEMPUR-PEDIC. I understand that I may terminate my employment with or without cause and with or without notice at any time. I further agree that TEMPUR-PEDIC reserves the right to make unilateral changes to the terms and conditions of my employment. I authorize TEMPUR-PEDIC or its agents to investigate my references and communicate with my former employers concerning my employment unless specifically stated otherwise in this application. I authorize all individuals, schools, and employers named, and all financial institutions, law enforcement agencies, and all persons except as specifically limited on this application to provide information requested about me, and I promise I will not bring any legal claims or actions against my current or former employers due to their responses to any job reference request. I further understand that the completion of an application with TEMPUR-PEDIC is a preliminary step to employment. It does not obligate TEMPUR-PEDIC to offer employment to me, or for me to accept employment. I further acknowledge that if offered employment, any offer of employment may be a conditional offer of employment pending successful completion of a drug screening and/or criminal background check.

Date:__________________, 20____

Signature:________________________________________________