Employment Application Name * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Have you ever been employed by this company? Yes No Have you ever applied for this company before? Yes No Position Applying For Reliability Service Technician Other Desired Start Date If applying for a position where driving is required, do you have a valid Commercial Drivers License? Yes No CDL Class (if applicable) Can you perform the essential functions of the job(s) for which you are applying? Yes No Are you prevented from lawfully becoming employed in this country because of visa or immigration status? Yes No Have you been convicted of a felony? (Please note that a “Yes” answer will not bar you from consideration of employment) Yes No If yes, please explain References List three (3) non-relatives who are familiar with your qualifications, work history, and ability. Please provide their name, occupation/relationship, number of years known, phone number, and email address. Employment Experiences Employer Supervisor Name Position Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Employed from (month/year to month/year) Duties Reason for Leaving May we contact this employer? Yes No Employer Supervisor Name Position Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Employed from (month/year to month/year) Duties Reason for Leaving May we contact this employer? Yes No Employer Supervisor Name Position Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Employed from (month/year to month/year) Duties Reason for Leaving May we contact this employer? Yes No PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK BEFORE SIGNING. I certify that all answers and statements I have made on this application (and resumé or other supplementary materials) are true and complete without omissions. By signing below, I authorize Hovden Oil to investigate all statements contained in this employment application as they may deem necessary in arriving at an employment decision. I understand that any false information provided by me will likely result in a refusal to hire or immediate discharge if I am employed. I authorize any of the persons or organizations named in this application to give you complete information and records regarding my employment, education, character, and qualifications. If hired, I will be responsible for familiarizing myself with all rules and regulations of Hovden Oil as they presently exist or are later modified. If hired, I understand my employment can be terminated at the discretion of Hovden Oil or at my option, without notice, at any time, and for any reason. I also understand that no representative of Hovden Oil has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the president of Hovden Oil. I understand this application is not an offer of employment and no promises or representations of employment have been made to me at this time. I have read, understand, and agree with the above. By typing my name below and submitting the application electronically this certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. Applicant's Signature Date MM DD YYYY This application is valid for only ninety (90) days from the date I signed. If I want to be considered for job openings more than ninety (90) days from date signed, I will submit a new application. Thank you for submitting your application for Firefly Reliability! We aim to review applications in a timely manner. You will be contacted by someone in Human Resources as soon as your application is reviewed. If you have any questions, please contact Kala Trojan at kala@hovdenoil.com.
