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An Equal Opportunity Employer Ameritherm, Inc. is dedicated to a policy of non-discrimination in employment. No question is asked for the purpose of excluding any applicant due to race, creed, color, national origin, religion, age, sex, disability, marital status, veteran status, sexual orientation or citizenship and any other characteristics protected by law.

Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Ameritherm.

Please inform Ambrell Human Resources if you need assistance completing any forms or to otherwise participate in the application process.

Name

Full Name: *

First

M.I.

Last

Address, Phone

Street Address

Address continued

City

State

Zip

Phone #:

()

Mobile #:

()

Fax #:

()

Education

Select the level of education you have completed.

Education *K - 8High SchoolCollegeGraduate Studies

School

Provide the name of college, university or vocational tech you attended

Degree

Indicate your concentration and type of degree you obtained, if applicable

Position

For which position are you applying?

Position *

Provide the title of the position for which you are applying.

Function *

Select the department most closely related to the position.

You can perform the essential functions of the position for which you are applying. (If you have questions as to what functions are applicable, please review the posted Job Description before you answer this question)

Essential Functions *YesNo

Explanation

If you cannot perform the essential functions, please provide an explanation.

How did you hear about this position?

Referrer

Details

Provide details about the referrer (name of publication, Job Board, employment agency or website)

Last Employer

Provide the name and address of your most recent employer.

Company Name *

Address *

Employment Began

Month *

Year *

yyyy

Employment Ended

Month *

Year *

yyyy

Indicate

salary level
title
reason for leaving

for this employer

Ending Salary *

Indicate $/hour or $/year

Job Title *

Ended due to... *

Can you provide information about a prior employer?

More info... *YesNo

Prior Employer

Provide the name and address of a prior employer.

Company Name *

Address *

Employment Began

Month *

Year *

yyyy

Employment Ended

Month *

Year *

yyyy

Indicate

salary level
title
reason for leaving

for this employer

Ending Salary *

Indicate $/hour or $/year

Job Title *

Ended due to... *

Can you provide information about another prior employers?

Even more info... *YesNo

Prior Employer

Provide the name and address of a prior employer.

Company Name *

Address *

Employment Began

Month *

Year *

yyyy

Employment Ended

Month *

Year *

yyyy

Indicate

salary level
title
reason for leaving

for this employer

Ending Salary *

Indicate $/hour or $/year

Job Title *

Ended due to... *

Can you provide information about another prior employers?

Still more info... *YesNo

Prior Employer

Provide the name and address of a prior employer.

Company Name *

Address *

Employment Began

Month *

Year *

yyyy

Employment Ended

Month *

Year *

yyyy

Indicate

salary level
title
reason for leaving

for this employer

Ending Salary *

Indicate $/hour or $/year

Job Title *

Ended due to... *

First Reference

Please provide the following information for someone with whom you have worked and who we may contact. Tell us how you know the reference, how long you've known them and what was your professional relationship.

Name

Phone *

Relationship *

How long known *

Can you provide information about another reference?

Another Reference... *YesNo

Second Reference

Name

Phone *

Relationship *

How long known *

Can you provide information about another reference?

Yet Another Reference... *YesNo

Third Reference

Name

Phone *

Relationship *

How long known *

Attachments

You can attach relevant electronic documents here; provide your cover letter and/or your resume (filesize limit 750k)

Cover Letter

Resume

Statements

IMPORTANT:

We are glad you are interested in joining the Ameritherm team. Please read the following statements carefully before you submit this application.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and pertinent information they may have, personal and otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I understand that this application is not a contract, offer, or promise of employment and that if hired, I will be able to resign at any time for any reason. Likewise, the company can terminate my employment at any time with or without cause, unless otherwise required by law. I understand that failure to reveal any prior employer, or giving false or misleading information on any part of this Application for Employment can be grounds for termination from the company or its subsidiaries. I further understand that no one other than the CEO of Ameritherm, Inc. has the authority to enter into an employment contract or agreement with me, and that my at-will employment can be changed only by a written agreement signed by the CEO of Ameritherm, Inc.

I understand that this application is good only for sixty (60) days from today’s date. If I still desire a position with the company after this application expires, it will be my responsibility to submit a new application and file it with the company. Otherwise, the company will not consider me for employment after this application expires.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

Check below that you have read, understood and agree to these statements...

Qualified applicants are considered for employment and employees are treated during employment without regard to race, color, religion, sex, national origin, age, marital status, sexual orientation, veteran status, disability or any other classification protected by Federal, State, or Local law.

Agreement *I agreeI do not agree

Invitation to Self-identify

Invitation to Self-Identify:

PLEASE READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING THIS FORM

Ameritherm is an Equal Opportunity Employer committed to the policies and principles of Non-Discrimination and Affirmative Action (AA). In order to evaluate and improve our recruiting processes and to respond to federal recordkeeping and reporting requirements, we invite you to complete this brief form. Providing this information is voluntary; refusal to provide the information will not result in any adverse treatment. Your information will be kept confidential and will be used only for government reporting purposes. If you choose not to self-identify your sex or race/ethnicity at this time, please select 'Self-identify NO' then 'SUBMIT', below. The federal government requires Ameritherm to determine this information by visual survey.

Self-identify? *YesNo

Self-Indentifications

Please select from these options:

White (Not of Hispanic origin) All persons having origins in any of the original peoples of Europe, North Africa or the Middle East.

Black or African American (Not of Hispanic origin) All persons having origins in any of the Black racial groups of Africa.

Hispanic or Latino All persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.

Asian All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent or the Pacific Islands. This area includes, for example, China, India, Japan, Korea

Native Hawaiian or other Pacific Islander

Native American All persons having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition.

Two or more races

Race or Ethnic Identity

Military VeteranYesNo

Are you a veteran of US military service?

Veteran Status

SexFemaleMale

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