Application for Employment"*" indicates required fieldsStep 1 of 714%We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital status, the presence of a non-job-related condition or handicap, or any other legally protected status.What position are you applying for?*How did you hear of this position?AdvertisementEmployment AgencyNational GuardsmanEmployee ReferralFriendRelativeWalk-InWhat is the name of the employee that referred you to us?Name* First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email ELIGIBILITYIf you are under 18 years of age, can you provide proof of your eligibility to work? Yes NoHave you ever filed an application with us before? Yes NoIf yes, please give the date: MM slash DD slash YYYY Have you ever been emplyed by us before? Yes NoIf yes, please give the date: MM slash DD slash YYYY Are you prevented from lawfully becoming employed in this country because of VISA or Immigration Status? Yes NoCan you provide proof of citizensip or immigration status? Yes NoAre you physically or otherwise unable to perform any of the duties of the job for which you are applying? Yes NoIf yes, please explain:Have you ever been convicted of a felony within the last 7 years?Conviction will not necessarily disqualify an applicant from employment. Yes NoIf yes, please explain:DRIVER APPLICANTS ONLYDo you currently have a Commercial Drivers License (CDL)? Yes NoAre you willing to test for a Commercial Drivers License (CDL)? Yes NoDo you currently have a Hazmat Endorsement? Yes NoAVAILABILITYOn what date would you be available to work? MM slash DD slash YYYY Are you available to work Full-Time Part-Time TempoaryAre you currently on "lay off" satus and subject to recall? Yes NoCan you travel if a job requires it? Yes NoEMPLOYMENT EXPERIENCEStart with your present or last job, include any related military service assignments and volunteer activities. you may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status.Employer*Job Title*Start Date* MM slash DD slash YYYY Current Employer?* Yes NoEnd Date* MM slash DD slash YYYY Reason for Leaving*Phone*Supervisor*May we contact this employer?* Yes NoWork Performed*Employer*Job Title*Start Date* MM slash DD slash YYYY End Date* MM slash DD slash YYYY Reason for Leaving*Phone*Supervisor*May we contact this employer?* Yes NoWork Performed*Employer*Job Title*Start Date MM slash DD slash YYYY End Date* MM slash DD slash YYYY Reason for Leaving*Phone*Supervisor*May we contact this employer?* Yes NoWork Performed*Employer*Job Title*Start Date* MM slash DD slash YYYY End Date* MM slash DD slash YYYY Reason for Leaving*Phone*Supervisor*May we contact this employer?* Yes NoWork Performed*Special Skills and QualificationsSummarize any special job-related skills and qualifications from employment or other experience. Add RemoveEDUCATIONYears of completed primary education9101112Did you graduate high school? Yes, I received my diploma No, but I have my GED No, I did not graduateYears of education beyond highschool01234What was your course of study?Describe any specalized training, apprenticeship, skills and extra-curricular activities:Describe any honors you have received:List professional, trade, business or civic activities and offices held:You may exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, handicap or other protected status. Add RemoveState any additional information you feel may be helpful to us in considering your application:REFERENCESGive three (3) references who are not related to you and are not your previous employers.Reference #1 - Name*Relationship*Phone*Reference #2 - Name*Relationship*Phone*Reference #3 - Name*Relationship*Phone*This field is hidden when viewing the formUntitled* I grant Nelson's Oil & Gas, Inc. permission to contact any of these references I wish Nelson's Oil & Gas, Inc. to contact only select references Please do not contact any of my referencesPlease only contact these references:* #1 #2 #3Applicant's Statement*I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving to an employment decision. This application for employment shall be considered active for a period not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. The applicant understands that neither this document nor any offer of employment from the employer constitute an employment contract unless a specific document to that affect is executed by the employer and employee in writing. in the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all the rules and regulations of the employer. I have read & agree to the applicant statement above.Signature*CAPTCHAΔ
