Online Application Step 1 of 6 16% APPLICANT INFORMATIONPosition(s) Applied ForDate MM slash DD slash YYYY Select one of our locations:El Reno, OklahomaBelle Fourche, South DakotaCanadian, TexasGiddings, TexasKilgore, TexasMexia, TexasOdessa, TexasTroy, TexasFirst NameLast NameMiddle NameAddress Street Address City State Zip Home PhoneCell PhoneEmail Address Date Available MM slash DD slash YYYY Pay DesiredAre you willing to work overtime, weekends, or travel as necessary to perform the job for which you are applying? Yes No Are you able to perform all of the essential functions of the job for which you are applying with or without reasonable accommodations? Yes No Have you ever worked for this company before? Yes No If Yes, when MM slash DD slash YYYY LocationAre you over the age of 18? Yes No Are you legally eligible for employment in the US? Yes No Have you ever been convicted of a felony? Yes No Have you been convicted of a misdemeanor in the last 5 years? Yes No Are you currently out on bail, the subject of a current warrant for arrest, or released on your own recognizance? Yes No Do not consider convictions labeled "Youthful Offender" or "Juvenile". If yes to any questions above concerning charges, please describe the nature of the charges/convictions: PAST LIVING HISTORY List all places ou have lived over the last 7 years. City, Country, StateFrom MM slash DD slash YYYY To MM slash DD slash YYYY City, Country, StateFrom MM slash DD slash YYYY To MM slash DD slash YYYY City, Country, StateFrom MM slash DD slash YYYY To MM slash DD slash YYYY City, Country, StateFrom MM slash DD slash YYYY To MM slash DD slash YYYY EDUCATION College Name/Location of SchoolCourse of StudyYears CompletedDid you graduate?Diploma/ DegreeHigh School Name/Location of SchoolCourse of StudyYears CompletedDid you graduate?Diploma/ DegreeOther Name/Location of SchoolCourse of StudyYears CompletedDid you graduate?Diploma/ DegreeList any other certifications, classes, or qualifications that may help you qualify for the job. EMPLOYMENT HISTORY List most recent company first. Company NameAddressSupervisorPhone Number(s)Reason for LeavingDates Employed From MM slash DD slash YYYY To MM slash DD slash YYYY Hourly Rate/Salary StartingEndingJob Title / ResponsibilitiesMay we contact this employer if needed? Yes No Company NameAddressSupervisorPhone Number(s)Reason for LeavingDates Employed From MM slash DD slash YYYY To MM slash DD slash YYYY Hourly Rate/Salary StartingEndingJob Title / ResponsibilitiesMay we contact this employer if needed? Yes No Company NameAddressSupervisorPhone Number(s)Reason for LeavingDates Employed From MM slash DD slash YYYY To MM slash DD slash YYYY Hourly Rate/Salary StartingEndingJob Title / ResponsibilitiesMay we contact this employer if needed? Yes No REFERENCES List persons that have knowledge of your work performance.Person's Name / OccupationAddressPhone NumberEmail Address RelationshipYears KnownCompanyPerson's Name / OccupationAddressPhone NumberEmail Address RelationshipYears KnownCompanyPerson's Name / OccupationAddressPhone NumberEmail Address RelationshipYears KnownCompany APPLICANT'S STATEMENT "I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that, if employed, falsified statements on this application could be grounds for dismissal, regardless of the time elapsed before discovery. I also hereby agree if offered a position with the Company and as a condition of employment, to allow the Company to perform any legally permitted background check or physical, psychological, skill, drug and alcohol, or medical test it may require.""I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that, if employed, falsified statements on this application could be grounds for dismissal, regardless of the time elapsed before discovery. I also hereby agree if offered a position with the Company and as a condition of employment, to allow the Company to perform any legally permitted background check or physical, psychological, skill, drug and alcohol, or medical test it may require." I agree to the above terms
