ACT Resources Mining Application
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Email *
Date of application: *
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Name: *
Address: *
Phone number: *
Date of birth: *
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Email address: *
Emergency contact name and number: *
Are you a citizen of the United States? *
If no, are you authorized to work in the U.S.? *
Have you ever been convicted of a misdemeanor? *
If yes, please list the year of conviction and charge:
Have you ever been convicted of a felony? *
If yes, please list the year of conviction and charge:
Education: (Please select highest level of education completed) *
Do you have a valid driver's license? *
License classification:
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Please select any of the following certifications that you currently hold: *
Please select any mining certifications currently held: *
Military service: (Please list branch, dates of service, type of discharge, and current status)
Please list how many years of surface mining experience you have:
Please list how many years of underground mining experience you have:
Please select the type of position you are applying for: *
Are you willing to work overtime? *
Employment experience: (Please list previous employers, job title, dates of employment, and what, if any, type of equipment that you operated) *
May we contact your previous employers for a reference? *
Please list any surface mining equipment that you can run proficiently, as well as the amount of time you have on it:
Please list any heavy equipment that you can operate proficiently:
Are you currently working? *
Do you need to give notice to a current employer? *
Please list the preferred dates and times that you would be available to come in for an interview: *
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