Application For Employment APPLICANT GENERAL INFORMATION Date First Name * First Middle Name * Middle Last Name * Last Social Security Number (XXX-XX-XXXX) * Email * Home Phone * Mobile Phone Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Are you over the age of 18? * Yes No Please tell us your age? * What position are you applying for? * What is your desired salary? Employment desired? * Full-Time Only Part-Time Only Full Or Part-Time What days are you available to work? (check all that apply) Monday Tuesday Wednesday Thursday Friday Saturday Sunday How many hours can you work weekly? * Can you work nights? * Yes No If hired, when are you available to start your employment. * Would you like to upload a resume? Yes No Attach Resume Drop a file here or click to upload Choose File Maximum file size: 7.34MB EDUCATION & ADDITIONAL INFORMATION What is the highest level of education you have achieved? * High SchoolSome CollegeAssociate DegreeBachelors DegreeMasters Degree What degree did you receive? * School Name/Location (Full Address Please) Have you attended a business, professional, or trade school? * Yes No School Name/Location (Full Address Please) HAVE YOU EVER BEEN CONVICTED OF A CRIME? * Yes No If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation. Do you have a drivers license? * Yes No Drivers License Number * State of issue * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Date of expiration? * License Type (check all that apply) * Operator Commercial (CDL) Chauffeur What is your means of transportation to work? OFFICE/TECHNOLOGY SKILLS: Typing * Yes No WPM * Word Processing * Yes No WPM * 10-Key * Yes No PC/Mac * Yes No Other Skills: REFERENCES: Please list at least two references other than relatives or previous employers. Reference Name * Position * Company * Reference Email * Reference Phone * Reference Address * Reference Address Reference Address Reference Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal plus1 Add Another Reference minus1 Remove Reference EMERGENCY CONTACT: Please list an emergency contact that we may reach out to if necessary. Emergency Contact Name * Relation * Emergency Contact Phone Number * MILITARY AFFILIATION Have you ever been in the armed forces? * Yes No Specialty: Date Entered * Discharge Date Discharge Type Honorable DischargeGeneral DischargeOther Than HonorableBad Conduct Discharge (BCD)Dishonorable DischargeOfficer DischargeEntry Level Separation (ELS) Are you currently a member of the National Guard? Yes No WORK EXPERIENCE- Please show last 5 years starting with most recent job. 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Reason For Leaving? (Be Specific) plus1 Add Another Employer minus1 Remove Employer Work Experience Continued May we contact your present employer? * Yes No Did you complete this application yourself? * Yes No In not, who did? APPLICATION FORM WAIVER In exchange for the consideration of my job application by CNC OILFIELD SERVICES (hereinafter called “the company”), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of CNC OILFIELD SERVICES, or otherwise to change in any respect the employmentat-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President/General Manager of the Company. Both the undersigned and CNC OILFIELD SERVICES may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references and others, and hereby release the Company from any liability as a result of such contract. I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job related physical examinations. I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act. I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party. Signature Of Applicant * signature keyboard Clear Date This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications. Thank you for completing this application form and for your interest in our business. Submit CORPORATE OFFICE: Address: 503 Park Road Frierson, LA 71027 Phone: 318-584-7099 Email: recruiter@cncoilfield.com SITE LINKS HOME SERVICES ABOUT NEWS CAREERS CONTACT FollowFollowFollowFollow