Employment Application
An Equal Opportunity Employer
APPLICANT IDENTIFICATION
Full Name
*
First Name
Middle Name
Last Name
Current Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email Address
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Are you 18 years of age or older?
Yes
No
Please provide any special information we may need about your name or your use of another name for the Company to be able to check your work record and otherwise verify the information given in this Application
Are you being referred by a current Faurecia Franklin Employee?
*
Yes
No
If yes, what is the name of the employee at Faurecia Franklin that is referring you?
Have you ever filed an application here before?
*
Yes
No
Give dates.
Have you ever been employed here before?
*
Yes
No
Give dates.
Do you have any relatives that are current or former employees of the Company?
*
Yes
No
Please identify who.
If hired, can you provide the documents required by law to prove that are are legally able to work in the U.S?
*
Yes
No
Have you ever been terminated by an employer for any reason other than solely lack of work?
*
Yes
No
Please explain.
Are you able to perform all essential functions of the position(s) for which you are applying for with or without a reasonable accommodation by the Company?
*
Yes
No
Have you ever been convicted of a crime or are there any felony charges pending against you?
*
Yes
No
For each such matter: please explain the date and nature of the crime; whether or not you were incarcerated and, if so, when did your incarceration begin and how long did it last; your present status (awaiting trial, probation until..., etc.); and any other information you would like us to consider when evaluating your response. A criminal record is not necessarily a bar to employment, factors such as the age and nature of the offense, and rehabilitation, will be taken into account.
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TYPE OF EMPLOYMENT DESIRED
Preferred Position
*
General Operator
Set Up Tech
Welder
Maintenance Tech
Date you could begin working:
*
-
Month
-
Day
Year
Date
Shift Preference
*
1st Shift M-F 6:30 a - 3 p
2nd Shift: M-F 2:30 p - 11p
3rd Shift: M-F 10:30 p - 7 a
Any
The job for which you are applying for may require work on Saturdays, Sundays, holidays and evenings. If so, are you willing to work such a schedule?
*
Yes
No
If you answered no to the previous question, please explain why and what accommodation by the Company would be required.
EDUCATION
Your educational record will be considered only to the extent that it is relevant to the job sought.
Name of High School
*
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Academic Major
*
Grade Point Average
*
Have you attended/attending college or a trade school (including US Military Schools)
*
Yes
No
Name of College/Trade Schools (Including US Military Schools)
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Degree
GPA
Do you have additional education you would like to enter?
Yes
No
Name of College/Trade Schools (Including US Military Schools)
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Degree
GPA
Do you have additional education you would like to enter?
Yes
No
Name of College/Trade Schools (Including US Military Schools)
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Degree
GPA
Proficiencies
If you are applying for a position in which prototype shop skills, computer skills or secretarial/clerical skills are relevant, please answer the following (if you have questions about whether such skills are relevant, ask a Faurecia Human Resources representative.)
List all the makes and models of computers and operating systems with which you have had operations experience.
List all data processing,telecommunications, or office equipment on which you are proficient
List all computer languages with whichyou have experience
List all prototype shop machines andtools with which you have had operating experience.
List all the languages that you can speak andwrite along with degree and fluency.
*
United States Military Service
If you obtained any experience or skills while in military service that relate to the job for which you are applying, please describe the nature of your duties that led to the experience.
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EMPLOYMENT BACKGROUND
Employer
*
May we contact your previous employer?
*
Yes
No
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Name and Title of Supervisor
*
Employed From
*
-
Month
-
Day
Year
Date
Employed To
*
-
Month
-
Day
Year
Date
Your current or last position and duties
*
Your starting position and duties
*
Ending Base Pay
*
Other compensation (give details on current commission, incentives, bonuses, etc.)
Reason For Leaving
*
Do you have additional employers you would like to enter?
*
Yes
No
Employer
May we contact your previous employer?
Yes
No
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Name and Title of Supervisor
Employed From
-
Month
-
Day
Year
Date
Employed To
-
Month
-
Day
Year
Date
Your current or last position and duties
Your starting position and duties
Starting Base Pay
Ending Base Pay
Other compensation (give details on current commission, incentives, bonuses, etc.)
Reason For Leaving
Do you have additional employers you would like to enter?
Yes
No
Employer
May we contact your previous employer?
Yes
No
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Name and Title of Supervisor
Employed From
-
Month
-
Day
Year
Date
Employed To
-
Month
-
Day
Year
Date
Your current or last position and duties
Your starting position and duties
Starting Base Pay
Ending Base Pay
Other compensation (give details on current commission, incentives, bonuses, etc.)
Reason For Leaving
Comments and Accomplishments
Explain your primary area of specialization. If applying for administrative, management or technical positions, outline all programs designed or implemented. If applying for marketing/sales, detail your sales experience, the kind of products/services sold and the customers serviced. Note any other details which should be considered in reviewing your qualifications including professional affiliation,honors and awards, theses, publications, patents, etc. (You may exclude professional affiliations which may suggest the race, color, age, sex, national origin, religion, citizenship, disability, height, weight, marital and veteran status, or any other legally protected status of its members.)
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ACKNOWLEDGEMENTS, RELEASE OF CLAIMS AND OTHER IMPORTANT INFORMATION
I certify that information given herein and or other information I furnish you is true and complete to the best of my knowledge. I understand that the Company may investigate my work and personal history and verify all data given on this application, on related papers, and in interviews, but that it is not required to do so. I authorize all individuals,schools and employers named herein and all financial institutions, law enforcement agencies, and other persons, except as specifically limited on this application, to provide information requested about me, and I release them from liability for damages in providing this information. I understand and acknowledge that any misrepresentation or omission of facts by me can result in immediate discharge. I consent to random drug testing and searches of my personal property on Company’s premises, at the Company’s expense. I understand a refusal to take a test on request may result in a proper termination of the application process or my employment. All applicants being considered for employment may be tested for the following and other drugs or their metabolites: AMPHETAMINE (Uppers/Speed), COCAINE (Crack/Cocaine), BARBITURATES (Sleeping Pills), METHAQUALONE (Qualudes/SleepingPills), BENZODIAZ (Valium), PHECYP-PCP (Animal Tranquilizer), OPIATE (Heroine/Codeine), PROPAXYPHENE (Darvon), METHADONE (Heroin Addicts), CANNABINOID-THC (Marijuana). I authorize the medical clinic/testing laboratory to release any test results to the Company and the Company to use them as determining factor in the selection and retention of employees. Applicants offered positions may be required to pass a job-related physical examination before beginning work. I authorize release of examination results to the Company. Under the Michigan Persons With Disabilities Civil Rights Act and the Federal Americans with Disabilities Act, the Company has a legal obligation to accommodate an employee’s or job applicant’s handicap unless the accommodation would impose an undue hardship on the employer. A disabled individual may allege a violation against and employer regarding a failure to accommodate his or her disability under the Michigan Law only if the disabled individual notifies the employer in writing of the need for accommodations within 182 days after the date the disabled person knew or reasonably should have known that an accommodation was needed. I agree that, if employed, my employment and compensation shall be at the will of the Company and can be terminated, with or without cause, and with or without notice, at any time at the option of either the Company or me. No representations concerning the Company or my possible employment have been made to me. I agree that no Company manager, agent or employee, other than its President, has now or has had in the past, any authority to enter into any agreement for employment for any specified period of time or to make any representation or agreement which is contrary to, in addition to, or a modification of the above described at will employment relationship, or which would obligate the Company or affect my employment, and that any such agreement or representation must be in writing and signed by me and the President of the Company to be effective. If I become employed by the Company, I agree that in consideration of my employment I will not commence any action or suit which relates in any way to my employment and/or termination of my employment which would otherwise be timely, more than six (6)months after the date of the event giving me a right to relief, regardless of the circumstances of the event or termination, and I waive any longer statute of limitations to the contrary. All rights reserved by or granted to the Company in this Application shall not adversely affect other rights of the Company. This Application will only be considered for a 90-day period from its receipt by the Company. I may reapply. Faurecia is an equal opportunity employer and complies with the laws prohibiting discrimination on the basis of race, color, age, sex, national origin,religion, citizenship, disability, height, weight, marital or veteran status,or any other legally protected status.
I have read, understand, and agree to the above (ACKNOWLEDGEMENTS, RELEASE OF CLAIMS AND OTHER IMPORTANT INFORMATION)
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DISCLOSURE AND RELEASE
In connection with my application for employment with you, I understand that consumer reports may be requested by Faurecia Clean Mobility. These reports may include the following types of information: Names and dates of previous employers, Reason for termination of employment, Job performances, Work experience, Accidents, etc. I further understand that such reports may contain information concerning my driving record, credit, criminal records,school records, social security number and date of birth verification from the social security administration: etc., from Federal, State, other agencies and former employers which maintain such records. All those contacted will be held harmless and free of any legal liability. I authorize without reservation, any party or agency contacted by Faurecia Clean Mobility to furnish the above-mentioned information. I have the right to make a request to Faurecia Clean Mobility, upon proper identification, to request the nature and substance of all information in its files on me at the time of the request. I hereby authorize procurement of consumer report(s). This authorization shall remain on file and shall serve as ongoing authorization for you to procure consumer reports at any time during my employment (or contract) period.
I have read, understand, and agree to the above (DISCLOSURE AND RELEASE).
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