Employment Application | American Standard Manufacturing, Inc.

American Standard Manufacturing, Inc is an Equal Opportunity Employer. Applicants are considered on the basis of skills, experience and qualifications without regard to race, age, creed, color, national origin, sex, marital status or the presence of non-job-related medical disability or any other legally protected status.

PERSONAL DATA

Name*

First Last

Today's Date*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Cell Phone Number*

Home Phone Number

Email*

POSITION INFORMATION

Position Desired

Starting Salary Desired

How were you referred to us?

In accordance with the Federal Immigration and Reform Act of 1986, if you are employed by our Company you will be asked to provide documentation that verifies your legal right to work in the United States. If you cannot provide acceptable documentation, we cannot legally employ you.

Can you provide such documentation?*

Yes
No

Have you ever been convicted of a felony?*

Yes
No

If yes, please explain. Conviction does not automatically exclude you from consideration for employment.

Do you authorize a background investigation including prior employers, education and criminal records?*

Yes
No

Initial Here*

EDUCATIONAL INFORMATION

High School

Name/Location

Subjects Studied

Degrees or Credits

Junior College/Trade School

Name/Location

Subjects Studied

Degrees or Credits

University/College

Name/Location

Subjects Studied

Degrees or Credits

Graduate School

Name/Location

Subjects Studied

Degrees or Credits

WORK HISTORY

-- List most recent employer first. You may include military service and training.

Employer

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone

Supervisor's Name and Position

Date's of Employment (From)

Date's of Employment (To)

Type of Business

Position Held

Reason for Leaving

May we contact this employer now?

Yes
No

Responsibilities

Employer

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone

Supervisor's Name and Position

Date's of Employment (From)

Date's of Employment (To)

Type of Business

Position Held

Reason for Leaving

May we contact this employer now?

Yes
No

Responsibilities

Employer

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone

Supervisor's Name and Position

Date's of Employment (From)

Date's of Employment (To)

Type of Business

Position Held

Reason for Leaving

May we contact this employer now?

Yes
No

Responsibilities

REFERENCES

-- List people who know your work. Do not include personal references.

Name*

First Last

Professional Relationship*

Work Telephone Number

Email

Name*

First Last

Professional Relationship*

Work Telephone Number

Email

Name

First Last

Professional Relationship

Work Telephone Number

Email

THE FOLLOWING POINTS ARE VERY IMPORTANT. PLEASE READ THEM CAREFULLY BEFORE SIGNING THIS APPLICATION.

I authorize investigation of all statements contained in this application. I will not hold American Standard Manufacturing, Inc. or any of my previous employers liable in any respect if an employment offer is not forthcoming, is withdrawn, or if my employment is terminated as a result of misrepresentation or omission of facts on this application. I understand that if I am emyployed by American Standard Manufacturing, Inc. additional personal data may be required for determination of benefits, statistical purposes and legal compliance

I understand that all offers of employment are conditional on my successfully completing a urinalysis for the purpose of detecting alcohol and/or illegal drugs. This will be performed at the Company designated medical facility and at the Company's expense. I further understand that if alcohol and/or illegal drugs are found in my system, all offers of employment will be withdrawn.

I also understand that if I am employed by the Company, my employment is "at will", that I or the Company may terminate the employment relationship at any time, for any reason, with or without notice. I further understand that no employee of the Company has the authority to modify this understanding orally or in writing except with the written permission of the President and CEO of American Standard Manufacturing, Inc.

I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND EACH AND ALL OF THESE STATEMENTS:

Signature (Acknowledgment)*

Date*

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