Email

Desired Rate of Pay

$

Please provide any additional information such as special skills, training, experiences, equipment operation, or other qualifications you feel will be helpful to us in considering your application.

Equal Opportunity Employer

All statements made by applicants for employment on this application form will be checked for accuracy. We offer equal employment opportunities to all persons without discrimination on the basis of race, color, religion, age, sex, national origin, citizenship status, physical or mental disability, or past, present, or future service in the Uniformed Services of the U.S., or any other legally protected status. The use of this form does not mean there are positions open and does not obligate us in anyway.

Prior Work Record

Start with most recent or present employer and complete in full.

Employer 1

Name of employer, contact information, Date of Employment and Starting Rate.

Employer 2

Name of employer, contact information, Date of Employment and Starting Rate.

Employer 3

Name of employer, contact information, Date of Employment and Starting Rate.

Education

Highest Education

References

Do not list relatives or former employers.

Reference 1

Reference Name, contact information, and relationship.

Reference 2

Reference Name, contact information, and relationship.

Reference 3

Reference Name, contact information, and relationship.

Job Applicant's Agreement and Certification

I certify that the information given by me in this application is true in all respects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient cause for denial of employment or discharge. I authorize the use of any information in this application to verify my statements, and I authorize past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from any liability or damages on account of having furnished such information. I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the company and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the company unless made in writing. If an employment relationship is established, I understand that I have the right to terminate my employment at any time and that the company retains the same right. If I am offered employment, I agree to submit to a physical examination whenever requested, and I understand my becoming employed and/or my continued employment are subject to the results of any physical examination related to my job duties in accordance with company policies and procedures. I understand that if employed, policies and rules which are issued are not conditions of employment and that the employer may revise policies or procedures in whole or in part, at any time. I understand that this application will be kept on active file for 60 days from the date completed, after which I would have to reapply in accordance with established company procedures.

Application for Fuel/Lube Truck Driver

Location

Hours

Contact