CAREERS DON'T JUST GET A JOB—START A CAREER! Employee Application Position Desired:* Personal Information Name* First Middle Last Social Security Number* D.O.B:* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Cell Phone* Home Phone Do you have a valid Drivers License?* Yes No If so, state & number: Desired Salary:* Have you worked for this company before?* Yes No If yes, reason for leaving: Are you employed now:* Yes No If not, how long since leaving last employment: How did you hear from us? What languages do you speak:* Write:* Read:* Education: Highest Grade Completed:* 1 2 3 4 5 6 7 8 High School:* 1 2 3 4 College:* 1 2 3 4 Work Eligibility: Are you eligible to work in the United States?* Yes No Are you available to work holidays?* Yes No When will you be able to start?* Are you 18 or older?* Yes No List your experience in the following areas: Production Separators* 0 years 0-1 years 1-3 years 3-5 years 5-10 years 10+ years Tank Batteries* 0 years 0-1 years 1-3 years 3-5 years 5-10 years 10+ years Pumping Units* 0 years 0-1 years 1-3 years 3-5 years 5-10 years 10+ years Lease Operations* 0 years 0-1 years 1-3 years 3-5 years 5-10 years 10+ years Fence Building* 0 years 0-1 years 1-3 years 3-5 years 5-10 years 10+ years General Construction* 0 years 0-1 years 1-3 years 3-5 years 5-10 years 10+ years General Maintenance* 0 years 0-1 years 1-3 years 3-5 years 5-10 years 10+ years OSHA Safety Standards* 0 years 0-1 years 1-3 years 3-5 years 5-10 years 10+ years Do you have special training skills that would be beneficial to Triple B Oilfield? Availability: Days Available* Sunday Monday Tuesday Wednesday Thursday Friday Saturday Total hours available:* Hours Available: From* to* Employment History: Please give an accurate and complete full-time employment record. Start with present or most recent employer. Include military experience if applicable. Position #1 Company Name City State Company Phone Number: Job Title: Name of Supervisor: Employed From: Month Day Year To: Month Day Year Weekly Pay: Describe your work: May we contact this employer? Yes No If not, why? Reason for leaving: Position #2 Company Name City State Company Phone Number: Job Title: Name of Supervisor: Employed From: Month Day Year To: Month Day Year Weekly Pay: Describe your work: May we contact this employer? Yes No If not, why? Reason for leaving: Position #3 Company Name City State Company Phone Number: Job Title: Name of Supervisor: Employed From: Month Day Year To: Month Day Year Weekly Pay: Describe your work: May we contact this employer? Yes No If not, why? Reason for leaving: Have you ever been convicted of or plead no contest to a felony within the last five years?* Yes No If yes, please explain: Have you ever been convicted of, plead guilty to, or plead no contest to, an act of dishonesty, or breach of trust or moral turpitude, such as misdemeanor petty theft, burglary, fraud, writing bad checks, and other related crimes within the past five years?* Yes No Conviction of a crime, or pleading guilty to a criminal charge, will not necessarily disqualify you from the job for which you are applying. Each conviction or plea will be considered with respect to time, job relatedness, and other relevant factors. If yes, please explain: I declare the information provided by me in this application is true, correct, and complete to the best of my knowledge. I understand that if employed, any falsification, misstatement, or omission of fact in connection with my application, whether on this document or not, may result in immediate termination of employment. I authorize you to verify any and all information provided above. Signature:* Typing my name above counts as signature. Date* MM slash DD slash YYYY DRUG FREE WORK PLACE I acknowledge that employment will be conditional upon successful completion of a substance abuse screening test as part of the Company's pre-employment policy. I also acknowledge that I may be subjected to random drug testing during my employment at Triple B Oilfield Service, Inc. Signature:* Typing my name above counts as signature. Date* MM slash DD slash YYYY Triple B Oilfield Services Inc. GET IN TOUCH P.O. Box 791, Elk City, OK 73648 580-243-6553 tripleboilfieldservice@gmail.com ABOUT US Founded July 20, 2004, Triple B Oilfield Service, Inc. has over 60 employees, operates five divisions, and continues to have record sales growth. ©2016 Triple B Oilfield Services Inc. | Designed by Wooster Creative