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Employment Application
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Last Name
First Name
M.I.
Street Address
Apartment/Unit #
City
State
ZIP
Mailing Address same as above
Mailing Address
City
State
ZIP
County/Parish
Country
Phone
Alt. Phone
Email
Emergency Contact
Phone
Alt. Phone
Emergency Contact Street Address
State/ZIP
Relation to Applicant
Date of Birth
Date Available
Desired Position
Are you a citizen of the United States?
YES
NO
If no, are you authorized to work in the U.S.?
YES
NO
Have you ever been convicted of a felony?
YES
NO
If yes, explain:
Have you ever worked for Montco Oilfield Solutions?
YES
NO
If so, when?
Years of experience in Oil and Gas Industry:
Driver's License
YES
NO
Driver's License Number
State Issued
Expiration Date
Passport
YES
NO
Expiration Date
**REFERENCES - Please list three professional references**
Relationship
Company
Phone
Address
**REFERENCES - Please list three professional references**
Relationship
Company
Phone
Address
**REFERENCES - Please list three professional references**
Relationship
Company
Phone
Address
PREVIOUS EMPLOYMENT:
Phone
Address
Supervisor
Job Title
Responsibilities
Employed From:
To:
Reason for Leaving
May we contact your supervisor for a reference?
YES
NO
PREVIOUS EMPLOYMENT:
Phone
Address
Supervisor
Job Title
Responsibilities
Employed From:
To:
Reason for Leaving
May we contact your supervisor for a reference?
YES
NO
MILITARY SERVICE:
From:
To:
Rank at Discharge
Type of Discharge
If other than honorabble, explain:
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
I certify that Montco Oilfield Solutions has my permission to implement any screening procedures, as the company deems adequate. These screening procedures include a background screening, reference check from previous employers, etc...
Signature
Date
SUBMIT