AISIN Industrial Park

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AISIN ILLINOIS, LLC

PRE-PLACEMENT HISTORY

Notice to all applicants: If an offer has been made, it is conditional upon your undergoing a pre-employment medical questionnaire, physical and drug test at a clinic of Aisin Mfg. Illinois, LLC's choice and at no cost to you. Upon satisfactory completion of a pre-employment screening, then and only then, will a job offer be complete.

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation or any other legally protected status.

Which application are you filing:

Position(s) Applied For

How did you learn about us? Other

Last Name
First Name
Middle Initial
Street Address
City
State
Zip Code
Phone Number --
Social Security # --

Are you 18 years of age or older? Yes No

Have you ever filed an application with us or Aisin before? Yes No
If yes, give date //

Have you ever been employed with us or Aisin before? Yes No
If yes, give date //

Are you currently employed? Yes No

May we contact your present employer? Yes No

Are you eligible to work in the U.S.? Yes No

(Proof of citizenship or immigration status will be required upon employment)

What shift do you prefer? 1st 2nd 3rd

Are you willing to work other shifts? Yes No

If yes, what shifts? 1st 2nd 3rd

Have you ever been convicted of or pleaded guilty to a felony? Yes No

You are not obligated to disclose sealed or expunged records of conviction or arrest

If yes, give each date, place and sentence or fine received and describe in detail the crime you were convicted of committing. criminal convictions are not an absolute bar to employment, and will only be considered in relation to specific job requirements.

Have you ever been terminated or asked to resign Yes No

If yes, give details, including employer, immediate supervisor, date of termination or resignation, and reason.