Full Name
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Position Applied for:
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--- Select Position ---
Directional Drilling – Crew Foreman/Lead
Directional Drilling – General Laborer
Directional Drilling – Operator Locator
Geothermal – Rig Foreman
Geothermal – Rig Helper
Geothermal – Tie-In Foreman
Geothermal – Tie-In Helper
Geothermal – Tie-In Operator
Accounting Assistant
How did you hear about this opportunity?
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Date
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Phone
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Address
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City
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State/Province
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Zip
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Email
Date Available to Start:
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Desired pay rate:
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Please answer the questions by checking the appropriate box
If you have any limitations on the hours that you can work, please explain:
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If yes, who?
EDUCATION:
High School:
City / State
College Degree (if applicable)
College:
City / State
College Degree (if applicable):
Other
City / State
Other Degree (if applicable):
Previous Employer1
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Phone
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Supervisor
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Address(City/State)
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Job Title
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Job responsibilities & duties
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Start Date
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End Date
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Reason for leaving
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Professional Reference #1:
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Relationship
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Phone
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Professional Reference #2:
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Relationship
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Phone
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Professional Reference #3:
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Relationship
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Phone
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SKILLS & QUALIFICATIONS:
List any skills, course work, certificates, and licenses that you’ve acquired that would be of benefit to you for the position that you are applying for
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DRIVER INFORMATION:
If yes, list the endorsements that you have
When does your current license expire?
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If yes, when does it expire?
DRIVING EXPERIENCE:
Equipment Description
Straight Truck
Type (Van, tank, flat, etc.)
Dates (years)
Approx. total miles
Equipment Description
Tractor & Semi
Type (Van, tank, flat, etc.)
Dates (years)
Approx. total miles
Equipment Description
Other
Type (Van, tank, flat, etc.)
Dates (years)
Approx. total miles
If yes, list the training
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Most recent accident
Description of Accident
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Date
List Injuries
Fatalities?
Most recent accident
Most recent accident
Description of Accident
Date
List Injuries
Fatalities?
.
#1
Violation
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City/State
Date
Penalty
2
#2
Violation
City/State
Date
Penalty
ADDITIONAL INFORMATION:
(list any info. about yourself here that you care to add)
1.Certification of Truthfulness
I certify that all statements on this application for employment and any attached resume are made completely,truthfully, and without evasion, and further understand and agree that such statements may be investigated and if found to be false will be sufficient reason for not being employed, or if employed, may result in my dismissal.
2. Authorization for Release of Information
I authorize the references and any academic institution I have listed above, and any prior or current employer of mine, to give The Hole Deal, Inc. any information concerning my previous employment or education, including any disciplinary information, and any pertinent information they may have, personal or otherwise. I release all parties from liability for any damage that may result from furnishing this information to The Hole Deal, Inc. Also, I hereby waive any right to receive written notice that employment information is being provided by any person or organization
3. Authorization to Obtain Motor Vehicle Record & Background Check
I authorize The Hole Deal, Inc. to obtain a report from any state or local agency concerning my motor vehicle operator’s record. I furthermore authorize The Hole Deal, Inc. to obtain a background check on me. I understand that the information contained in those records may be considered in determining my eligibility for employment. I also understand that if I am hired, The Hole Deal, Inc. has the right to obtain a report of my motor vehicle operator’s record & background check from time to time, and that such records may be considered in determining my eligibility qualifications for continued employment.
4. Employment at Will
If hired, in consideration of my employment, I agree to abide by the rules and policies of The Hole Deal, Inc. I further agree that such employment and all compensation can be terminated with or without cause, and with or without notice, at any time, at the option of either The Hole Deal, Inc. or myself. I understand that no agent or representative of The Hole Deal, Inc. has any authority to make any agreement contrary to the foregoing, except by a written employment contract signed by the President of The Hole Deal, Inc.
Date
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