Employment Application

Instructions for Completion:

1. All documents must be completed by the applicant.

2. A Pro Oil & Gas representative should becontacted if assistance is required completing this form.

3. If you have no response for any question or section, write“N/A” in response area.

Application for Employment

First Name

/

M.I.

/

Last Name

/ Jr.
Sr. / Office Use Only
District Code:

Address

/
City
/ State / Zip

Email Address

/ Cell Phone (area code & number) / Home Phone (area code)

Position You Are Applying For

/

Full Time

Part Time

/ Desired Pay / Date Available For Work
How Did You Learn Of This Company?
Briefly Describe Your Qualifications For The Position You Are Applying For
List Any Mechanical Experience and/or Any Machinery Or Business Equipment You Have Operated
______
Do you possess a valid Commercial Driver’s License? Yes No If Yes, what state?
Are You Familiar With Any Foreign Languages? (Indicate which and if you can read, speak, or write)
EDUCATION

Name & Location Of School

/

Yrs Attended

/ Major / Completed/Degreed?

Grammar School

/ (List Favorite Subjects)

Jr. High

School

Sr. High

School

College

Trade/

Technical
School
List Professional / Technical Certifications, Licenses, Memberships (attach additional page if needed)
EMPLOYMENT HISTORY
Complete all areas as requested. Applicants are expected to provide a complete work history for the past 5 years or since completion of school as listed in the “Education” section.

Company Name (Present Employer)

/ Type of Business / Phone No. & Area Code

Address

/ City, State, Zip Code / Immediate Supervisor
Dates
Employed /

From

/

To

/ Job Title/Position / List Duties
Reason For Leaving / Starting Pay / Ending Pay
Verified By

Company Name

/ Type of Business / Phone No. & Area Code

Address

/ City, State, Zip Code / Immediate Supervisor
Dates
Employed /

From

/

To

/ Job Title/Position / List Duties
Reason For Leaving / Starting Pay / Ending Pay
Verified By

Company Name

/ Type of Business / Phone No. & Area Code

Address

/ City, State, Zip Code / Immediate Supervisor
Dates
Employed /

From

/

To

/ Job Title/Position / List Duties
Reason For Leaving / Starting Pay / Ending Pay
Verified By
REFERENCES
Please list Three (3) Work or Personal References. Please do not list family members or relatives.

Name

/ Type of Business / Years Known / Phone No. & Area Code
EMERGENCY CONTACT INFORMATION
In The Event Of An Emergency, PROOil & Gas Services, LLC should contact:

Name

/ Address / Relationship / Phone No. & Area Code

EQUAL OPPORTUNITY EMPLOYMENT

APPLICANT: READ AND INITIAL EACH SECTION

______PRO OIL & GAS SERVICES, LLC IS AN EQUAL OPPORTUNITY EMPLOYER. IT IS THE POLICY OF PROOIL & GAS SERVICES, LLC TO PROVIDE EQUAL EMPLOYMENT OPPORTUNITIES TO ALL EMPLOYMENT APPLICANTS, AS WELL AS EMPLOYEES, WITHOUT REGARD TO RACE, NATIONAL ORIGIN, AGE, SEX, DISABILITY, CITIZENSHIP, AND VETERAN STATUS.

CERTIFICATIONS AND ACKNOWLEDGEMENTS REGARDING APPLICATIONS AND EMPLOYMENT

______ I ACKNOWLEDGE AND AGREE THATANY FALSE INFORMATION, MISINFORMATION, AND/OR OMITTED INFORMATION (INLCUDING INFORMATION GIVEN OR WITHELD BY ME AT THE TIME OF MY PHYSICAL EXAMINATION/ASSESSMENT) SHALL CONSTITUTE FALSIFICATION OF THIS ENTIRE APPLICATION FOR EMPLOYMENT, AND WILL BE CONSIDERED GROUNDS FOR REJECTION AND/OR IMMEDIATE TERMINATION OF MY EMPLOYMENT. I FURTHER UNDERSTAND AND AGREE THAT, BY MY FALSIFICATION OF THIS DOCUMENT, I HAVE NO RIGHTS TO EMPLOYMENT.

______ SHOULD I BECOME EMPLOYED BY PRO OIL & GAS SERVICES, LLC, I ACKNOWLEDGE AND UNDERSTAND THAT MY EMPLOYMENT IS “AT WILL”. I UNDERSTAND THAT “AT WILL” EMPLOYMENT PROVIDES THAT:

  • I MAY TERMINATE MY EMPLOYMENT AT ANY TIME, WITH OR WITHOUT NOTICE, FOR ANY REASON, AND THAT THERE HAVE NOT BEEN ANY CONTRARY REPRESENTATIONS, ORAL OR WRITEN, MADE TO ME BY ANY PARTY, AND THAT THE PRESIDENT OF PRO OIL & GAS SERVICES, LLC IS THE ONLY PERSON THAT CAN AGREE TO MODIFY/CHANGE THIS PROVISION OF MY EMPLOYMENT RELATIONSHIP.
  • PROOIL & GAS SERVICES IS EQUALLY AT RIGHT TO TERMINATE MY EMPLOYMENT FOR CAUSE OR NOT AT ANY TIME AND WITHOUT NOTICE.

______
APPLICANT SIGNATURE

APPLICANT: READ AND INITIAL AND/OR SIGN IN THE DESIGNATED AREA

SPECIFIC CONSENT FOR ALCOHOL/DRUG SCREENING

______ I, THE UNDERSIGNED APPLICANT, HEREBY GIVE MY CONSENT TO PRO OIL & GAS SERVICES, LLC AND/OR ITS AGENT/REPRESENTATIVE TO COLLECT URINE, BLOOD, AND/OR BREATH SAMPLES FROM ME FOR THE PURPOSE OF TESTING TO DETERMINE THE PRESENCE OF ALCOHOL, DRUGS, OR ANY CONTROLLED SUBSTANCES, AS DEFINED IN PRO OIL & GAS SERVICES, LLC’S SUBSTANCE ABUSE POLICY, GUIDELINES, AND/OR OTHER PRACTICES/PROCESSES RELATED TO THE ELIMINATION OF SUBSTANCE ABUSE IN THE WORKPLACE.

______ I ALSO GIVE MY CONSENT FOR THE RELEASE OF ANY AND ALL TEST RESULTS TO THOSE ENTITIES AND/OR PERSONS DEEMED BY PRO OIL & GAS SERVICES TO HAVE A NEED TO ACCESS SAID RESULTS.

I ACKNOWLEGE AND UNDERSTAND THAT MY REFUSAL TO SUBMIT TO A DRUG AND/OR ALCOHOL TEST, FALSIFICATION OF A TEST, TAMPERING WITH A SAMPLE OR TEST, OR TESTING POSITIVE ON A TEST WILL RESULT IN A DENIAL FOR EMPLOYMENT AND/OR IMMEDIATE TERMINATION OF MY EMPLOYMENT.

I FURTHER ACKNOWLEDGE AND AGREE THAT THE RESULTS OF SUCH TESTING MAY BE DISCLOSED TO AUTHORIZED MEMBERS OF PRO’s MANAGEMENT AND/OR CUSTOMER ENTITIES IF SUCH IS REQUIRED IN MY CURRENT EMPLOYMENT.THESE TEST RESULTS WILL BE CONSIDERED IF DETERMINING WHETHER MY EMPLOYMENT WITH PRO OIL & GAS SERVICES, LLC WILL CONTINUE.

Applicant’s Printed NameWitness’ Printed Name

Applicant’s SignatureDateWitness’ SignatureDate

In connection with your application for employment (including contract for services), understand that consumer reports or investigative consumer reports which may contain public record information may be requested or made on you including consumer credit, criminal records, driving record, education, prior employer verification, workers compensation claims and others. These reports will include experience information along with reasons for termination of past employment. Further, understand that information from various Federal, State, local and other agencies which contain your past activities will be requested. A consumer report containing injury and illness records and medical information may be obtained only after a tentative offer of employment has been made.

By signing below, you hereby authorize without reservation, any party or agency contacted by this employer to furnish the above mentioned information. You further authorize ongoing procurement of the above mentioned reports at any time during your employment (or contract). You also agree that a fax or photocopy of this authorization with your signature be accepted with the same authority as the original.

You have the right to make a request of First Advantage, upon proper identification and the payment of any legally permissible fees, for the information in its files on you at the time of your request.

You hereby authorize and request, without any reservation, any present or former employer, school, police department, financial institution, division of motor vehicles, consumer reporting agencies, or other persons or agencies having knowledge about you to furnish First Advantage with any and all background information in their possession regarding you, in order that your employment qualifications may be evaluated.

For California, Minnesota or Oklahomaapplicants only, if you would like to receive a copy of the consumer report, if one is obtained, please check this box. If checked and you are a California applicant, a copy of the consumer report will be sent within three (3) days of the employer receiving a copy of the consumer report.

For California applicants only, if public record information about your character, general reputation, personal characteristics, and mode of living is obtained without using a consumer reporting agency, you will be supplied a copy of the public record information within seven (7) days of the employer’s receipt unless you check this box where you hereby waive your right to obtain a copy of the consumer report. 

Have you ever been convicted of a Felony? (Yes/No) If Yes, please explain:

Print your Name:______

Street Address: ______

City: State: Zip: ______

Social Security Number: ______

Driver’s License State: ______Driver’s License Number: ______

Applicant Signature: ______Date: ______

The following is for identification purposes only to perform the background check:

Date of Birth (MM/DD/YYYY): ______

Other or Former Names: ______

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