Amdrill, Inc. is an equal opportunity employer and DFW prohibiting discrimination on the basis on race, color, sex ,age, religion, national origin, disability, marital status and any other characteristic protected by local, state or federal law. Original forms of employment eligibility and identity will be required if employed.
* Required Field
First Name *
Last Name *
Social Security # *
Address *
Phone *
Alt. Phone
E-Mail *
Are you over the age of 21? * YesNo
Are you legally eligible for employment in the US? * YesNo
Position Applying for
Date available to start
Referred by
Days & Hours Available
Type of employment desired Full TimePart TimeTemp
Wage Desired $
Per
Have you ever applied for a position with our company before? YesNo
If yes, when?
.
High School (Institution & Location)
GED/Gradute? N/AYesNo
Major/Minor
College (Institution & Location)
GED/Graduate N/AYesNo
Other Education/Training (Institution & Location)
Reference Name 1 (No Relatives) *
Years Known MM/YY *
Until When MM/YY *
Company Reference 1 *
Reference Name 2 (No Relatives) *
Company Reference 2 *
Reference Name 3 (No Relatives) *
Company Reference 3 *
Address
Employer 1
Phone
Employment Date: MMYY
Until When MM/YY
Position
Supervisors Name
Duties
Reason for Leaving
May we contact your previous supervisor? N/AYesNo
Starting Salary $
Ending Salary $
Employer 2
Supervisor’s Name
May we contact your previous supervisor N/AYesNo
Employer 3
Branch
Date MM/YY
Until MM/YY
Rank at Discharge:
Type of Discharge
Other then honorable, Explain
All the information I have provided in writing, verbally, and in supplemental document is true and complete. I acknowledge that false or incomplete information may be cause to withdraw a job offer to terminate my employment. I acknowledge that there is no written or verbal employment at any time, with or without reason or notice, and that only the company President can establish and employment contract. I acknowledge that any offer of employment is contingent upon satisfactory work, education, credit when applicable, criminal background investigation, and a post-offer pre-employment drug screen. I authorize all references and former employers to provide information concerning me. I release all parties from any claims, causes of action, or liability from damages that ,ay result from furnishing information or as a result of information obtained through an investigation or drug screen.
Signature Of Applicant *
Date MM/DD/YY *
In compliance with the Fair Credit Reporting Act, this notice is given to inform you that Amdrill Inc. may obtain consumer reports from time to time for employment purposes. “Consumer Reports” are reports from consumer reporting agencies and may include driving records, criminal records and other reports.
I authorize Amdrill, Inc. to obtain consumer reports regarding me from time to time for employment purposes.
(include any licenses in past 5 years)
Signature *
Date MM/DD/YYYY *
Print Name
SSN *
Driver’s License Number *
State *
Date of Birth MM/DD/YYYY *
CDL Approved Driver (If Yes, attach pre-filled Certification of Violations/Annual Review of Driving Record, Form #643-FS-C2)) * YesNo
It if against Amdrill Inc.’s policy for anyone other than the employee to drive a company vehicle. It is also against Amdrill Inc.’s policy for the employee to drive Amdrill Inc.’s vehicle when not working.
I have read the forgoing and understand it is my responsibility to report to my employer any traffic violations or accidents immediately and that no one other than myself will be allowed to drive Amdrill Inc.’s vehicle in my possession.
