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Class A CDL Drivers


Petroleum Services
Application for Employment

* If field is not applicible, please enter 'none'.

Personal Information

* First Name:
* Middle Initial:
* Last Name:
* Home Phone: (###-###-####)
* Cell Phone: (###-###-####)
* Email:
* Social Security #: (999-99-9999)
* Date of Birth: (mm-dd-yyyy)
* Who referred you?
* Desired rate of pay

Residence (last three years)

Current Residency
* Address:
* City:
* State:
* Zip:
* How long:

Previous Residency
* Address:
* City:
* State:
* Zip:
* How long:

Previous Residency
* Address:
* City:
* State:
* Zip:
* How long:

 
* Have you ever been convicted of a felony?
If yes, please explain fully:

Conviction of a crime is not an automatic bar to employment. All circumstances will be considered.

* Have you ever tested positive or refused to be tested on a Pre-Employment Drug Screen for an employer that you did not go to work for?

* Please list any reason you might be unable to perform the functions of the job for which you have applied.




 


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