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Employee Application
Position Desired:
*
Personal Information
Name
*
First
Middle
Last
Social Security Number
*
D.O.B:
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Cell Phone
*
Home Phone
Do you have a valid Drivers License?
*
Yes
No
If so, state & number:
Desired Salary:
*
Have you worked for this company before?
*
Yes
No
If yes, reason for leaving:
Are you employed now:
*
Yes
No
If not, how long since leaving last employment:
How did you hear from us?
What languages do you speak:
*
Write:
*
Read:
*
Education:
Highest Grade Completed:
*
1
2
3
4
5
6
7
8
High School:
*
1
2
3
4
College:
*
1
2
3
4
Work Eligibility:
Are you eligible to work in the United States?
*
Yes
No
Are you available to work holidays?
*
Yes
No
When will you be able to start?
*
Are you 18 or older?
*
Yes
No
List your experience in the following areas:
Production Separators
*
0 years
0-1 years
1-3 years
3-5 years
5-10 years
10+ years
Tank Batteries
*
0 years
0-1 years
1-3 years
3-5 years
5-10 years
10+ years
Pumping Units
*
0 years
0-1 years
1-3 years
3-5 years
5-10 years
10+ years
Lease Operations
*
0 years
0-1 years
1-3 years
3-5 years
5-10 years
10+ years
Fence Building
*
0 years
0-1 years
1-3 years
3-5 years
5-10 years
10+ years
General Construction
*
0 years
0-1 years
1-3 years
3-5 years
5-10 years
10+ years
General Maintenance
*
0 years
0-1 years
1-3 years
3-5 years
5-10 years
10+ years
OSHA Safety Standards
*
0 years
0-1 years
1-3 years
3-5 years
5-10 years
10+ years
Do you have special training skills that would be beneficial to Triple B Oilfield?
Availability:
Days Available
*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Total hours available:
*
Hours Available: From
*
to
*
Employment History:
Please give an accurate and complete full-time employment record.
Start with present or most recent employer.
Include military experience if applicable.
Position #1
Company Name
City
State
Company Phone Number:
Job Title:
Name of Supervisor:
Employed From:
Month
Day
Year
To:
Month
Day
Year
Weekly Pay:
Describe your work:
May we contact this employer?
Yes
No
If not, why?
Reason for leaving:
Position #2
Company Name
City
State
Company Phone Number:
Job Title:
Name of Supervisor:
Employed From:
Month
Day
Year
To:
Month
Day
Year
Weekly Pay:
Describe your work:
May we contact this employer?
Yes
No
If not, why?
Reason for leaving:
Position #3
Company Name
City
State
Company Phone Number:
Job Title:
Name of Supervisor:
Employed From:
Month
Day
Year
To:
Month
Day
Year
Weekly Pay:
Describe your work:
May we contact this employer?
Yes
No
If not, why?
Reason for leaving:
Have you ever been convicted of or plead no contest to a felony within the last five years?
*
Yes
No
If yes, please explain:
Have you ever been convicted of, plead guilty to, or plead no contest to, an act of dishonesty, or breach of trust or moral turpitude, such as misdemeanor petty theft, burglary, fraud, writing bad checks, and other related crimes within the past five years?
*
Yes
No
Conviction of a crime, or pleading guilty to a criminal charge, will not necessarily disqualify you from the job for which you are applying. Each conviction or plea will be considered with respect to time, job relatedness, and other relevant factors.
If yes, please explain:
I declare the information provided by me in this application is true, correct, and complete to the best of my knowledge. I understand that if employed, any falsification, misstatement, or omission of fact in connection with my application, whether on this document or not, may result in immediate termination of employment. I authorize you to verify any and all information provided above.
Signature:
*
Typing my name above counts as signature.
Date
*
MM slash DD slash YYYY
DRUG FREE WORK PLACE
I acknowledge that employment will be conditional upon successful completion of a substance abuse screening test as part of the Company's pre-employment policy. I also acknowledge that I may be subjected to random drug testing during my employment at Triple B Oilfield Service, Inc.
Signature:
*
Typing my name above counts as signature.
Date
*
MM slash DD slash YYYY
