APPLICATION FOR EMPLOYMENT - Earth Energy Inc.
Earth Energy Inc. is an equal opportunity employer.
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Email *
APPLICANT INFORMATION
Last Name *
First Name *
Middle Initial *
Last four digits of your Social Security Number (SSN) *
Today's Date *
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Street Address *
Apartment/Unit #
City *
State *
ZIP Code *
Phone Number *
Date Available *
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Desired Hourly Wage *
Position Applied For *
Required
Are you a citizen of the United States? *
Required
If no, are you authorized to work in the United States?
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Have you ever worked for this company? *
If so, when?
EDUCATION
High School *
Address of High School *
What years were you in High School? *
Did you graduate High School? *
College
What years were you in College?
Did you graduate College?
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What did you get your degree in?
Other form of Education
What years did you receive this education?
Did you receive a form or certificate showing that you went through this education?
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REFERENCES
Please list non-relatives whom you have known for at least one year.
Full Name *
Relationship *
Company *
Phone Number of Company *
Address of Company *
Full Name *
Relationship *
Company *
Phone Number of Company *
Address of Company *
Full Name *
Relationship *
Company *
Phone Number of Company *
Address of Company *
PREVIOUS EMPLOYMENT
Please explain any gap in employment.
Company *
Company Phone Number *
Company Address *
Supervisor *
Job Title *
Starting Wage *
Ending Wage *
Responsibilities *
Worked there from when to when? *
Reason for Leaving? *
May we contact your previous supervisor for a reference? *
Company *
Company Phone Number *
Company Address *
Supervisor *
Job Title *
Starting Wage *
Ending Wage *
Responsibilities *
Worked there from when to when? *
Reason for leaving? *
May we contact your previous supervisor for a reference? *
Company *
Company Phone Number *
Company Address *
Supervisor *
Job Title *
Starting Wage *
Ending Wage *
Responsibilities *
Worked there from when to when? *
Reason for leaving? *
May we contact your previous supervisor for a reference? *
MILITARY SERVICE
Branch
From when to when?
Rank at Discharge
Type of Discharge
If other than honorable, please explain
DISCLAIMER
It is our policy not to discriminate against minorities or women with respect to recruitment, hiring, training, promotion and other terms and conditions of employment, provided the individual is qualified to perform the work available.
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
PERSONAL DRIVING HISTORY
Name *
Date of Birth *
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Drivers License Number *
What state is your Drivers License from? *
Have you held a Drivers License in any other state during the past three (3) years? If so, what state(s)? *
Have you had any accidents involving an automobile in the last three (3) years? If so, please explain. *
Have you had any driving violations in the last three (3) years? If so, what kind and approximate date. *
Have you ever been arrested for DUI, or refused to take an alcohol test? *
Do you have a Commercial Drivers License (CDL)? If so, what class? *
Are you registered on the DOT Clearinghouse? (Registration is free and must be completed as part of the interview process & when accepting employment with Earth Energy. Please see additional information attached.) *
I give permission to investigate my driving record and understand that a good driving record is a condition of my employment. *
As a part of my application for employment, I consent to take a drug test. *
Did a current employee at Earth Energy refer you to fill out our application? *
If so, what is their name?
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