Employment - Oilfield Careers - Fluid Technology Service

Date of application:*
MM slash DD slash YYYY
Name:*
Prefix First Last Suffix
Email:*
Please Input Your Current Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please Input Your Previous Address:*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Work Phone
Mobile Phone
Emergency Contact Name
First Last
Relationship
Were you ever employed with Fluid Technology Services? If yes, give your reason for leaving
How did you hear about Fluid Technology Services?

Please indicate the type(s) of work that you would prefer:
- Full-Time
- Part-Time
Approximately how many hrs per week do you wish to work?
Please enter a number from 0 to 80.
When are you available to begin work?*
MM slash DD slash YYYY
Please indicate the days and times that you are available for work:*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday

EMPLOYMENT EXPERIENCE
Your application will not be considered unless every question in this section is answered. Since we will make every effort to contact previous employers, the correct telephone numbers of past employers are essential.
Employer Name (1)
Address of Employer (1)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Dates Employed - From
MM slash DD slash YYYY
Dates Employed - To
MM slash DD slash YYYY
Starting Pay Rate(Monthly):
Supervisor's Name:
Supervisor's Phone:
May we contact this employer?
- Yes
- No
Job Title and Duties
Reason for Leaving

Previous Employment - Employer No.2
Employer Name (2)
Address of Employer (2)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Dates Employed - From
MM slash DD slash YYYY
Dates Employed - To
MM slash DD slash YYYY
Starting Pay Rate:
Final Pay Rate:
Supervisor's Name:
Supervisor's Phone:
May we contact this employer?
- Yes
- No
Job Title and Duties
Reason for Leaving

EMPLOYMENT EXPERIENCE
Previous Employment - Employer No.3
Employer Name (3)
Address of Employer (3)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Dates Employed - From
MM slash DD slash YYYY
Dates Employed - To
MM slash DD slash YYYY
Starting Pay Rate:
Final Pay Rate:
Supervisor's Name:
Supervisor's Phone:
May we contact this employer?
- Yes
- No
Job Title and Duties
Reason for Leaving
I certify that I have read and understand the applicant note on page one of this form and that the answers information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agent, including consumer-reporting bureaus, to verify any of this information including but not limited to, criminal history and motor vehicle driving records. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.

EDUCATION
Please describe your educational background in this section.
High School
High School Name:
Years Completed:
Diploma/Degree?
- Yes
- No
Describe Specialized Training, Experience, Skills and Extra- Curricular Activities:

EDUCATION
Please describe your educational background in this section.
College
College Name:
Years Completed:
Diploma/Degree?
- Yes
- No
Describe Course of Study or Major:
Describe Specialized Training, Experience, Skills and Extra- Curricular Activities:

EDUCATION
Please describe your educational background in this section.
Trade or Correspondence
Institution's Name:
Years Completed:
Diploma/Degree?
- Yes
- No
Describe Course of Study or Major:
Describe Specialized Training, Experience, Skills and Extra- Curricular Activities:

PERSONAL REFERENCES
Please list three personal references of individuals who are not related to you.
Personal Reference I
Professional Reference I - Name & Title
Professional Reference I - Relationship

(Example: Worked together at ABC Company for 3 years)
Professional Reference I - Telephone Number or Email
Professional Reference II
Professional Reference II - Name & Title
Professional Reference II - Relationship

(Example: Worked together at ABC Company for 3 years)
Professional Reference II - Telephone Number or Email
Professional Reference III
Professional Reference III - Name & Title
Professional Reference III - Relationship

(Example: Worked together at ABC Company for 3 years)
Professional Reference III - Telephone Number or Email

As a condition of employment all employees must be “Bondable”. List states and counties of residence for the past seven years:
Have you used any names or Social Security Numbers other than those of this application?*
- Yes
- No
If yes, please list the other name(s).
Have you ever pled guilty or "no contest" to, or been convicted of, a misdemeanor or felony?
- Yes
- No
If yes, please give the date(s) and details:

AUTHORIZATION FOR RELEASE OF EMPLOYMENT INFORMATION
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Social Security Number
Date of Birth*
I have applied for a position at Fluid Technology Services. I authorize you to respond to the reference request so they may act on my application. I release you from all liability in providing information regarding my employment with you.
Signature*
Date
MM slash DD slash YYYY
Captcha

Oilfield Jobs