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Employment Application: Employement/ Work History

The document is an employment application for Harrison Oilfield Services located in Moab, Utah that requests basic contact and employment history information as well as questions about convictions, injuries, and qualifications. If applying for a truck driving position, a current motor vehicle history report must be provided. Applicants sign to certify the truth of their statements and authorize verification of the application.

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Jimmy Voss
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68 views

Employment Application: Employement/ Work History

The document is an employment application for Harrison Oilfield Services located in Moab, Utah that requests basic contact and employment history information as well as questions about convictions, injuries, and qualifications. If applying for a truck driving position, a current motor vehicle history report must be provided. Applicants sign to certify the truth of their statements and authorize verification of the application.

Uploaded by

Jimmy Voss
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Harrison Oilfield Services, Inc.

1450 S. HWY 191


Moab, Utah 84532
(435) 259-6430

EMPLOYMENT APPLICATION
*If you are applying for and truck driving position you must provide a current copy of your motor vehicle
history report before your application will be review for employment.*

Name: ______________________________________________________ Date: ____________


Address: ____________________________ City: _____________ State: _______ Zip: _______
Home Phone: ___________________________ Cell Phone: ____________________________

Position(s) applying for: _________________________________________________________


Date you can start: ______________________ Desired Salary: __________________________

Have you ever been convicted of or charged with a felony? YES ____ NO _____
If yes, please explain details in full, including dates, details of offense(s) charged, location and disposition:
__________________________________________________________________________________________
Have you ever claimed a Workers Comp.? YES _____ NO _____ If yes, please explain and when: ___________
_________________________________________________________________________________________
Have you ever had a back injury, or any other injury? YES ______ NO _____If yes, please explain: __________

EMPLOYEMENT/ WORK HISTORY:


Employer: ____________________________________________ Supervisor: _______________________________
Address: ______________________________________________ Job Title: ________________________________
City/State/Zip: __________________________________________ Phone: __________________________________
Reason for Leaving: _____________________________________ Dates of employment: ______________________
Employer: ____________________________________________ Supervisor: _______________________________
Address: ______________________________________________ Job Title: ________________________________
City/State/Zip: __________________________________________ Phone: __________________________________
Reason for Leaving: _____________________________________ Dates of employment: ______________________
Employer: ____________________________________________ Supervisor: _______________________________
Address: ______________________________________________ Job Title: ________________________________
City/State/Zip: __________________________________________ Phone: __________________________________
Reason for Leaving: _____________________________________ Dates of employment: ______________________
REFERENCES:
NAME: __________________________________________ PHONE: ____________________________
NAME: __________________________________________ PHONE: ____________________________
NAME: __________________________________________ PHONE: ____________________________

EDUCATION:
High School: ____________________ Date attended: _________________ Diploma achieved: ___________

College Attended: ________________ Date attended: _________________ Diploma achieved: __________

College Attended: ________________ Date attended: _________________ Diploma achieved: __________

SPECIAL SKILLS:
Please describe any special skills and additional qualifications: __________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

CERTIFICATION OF APPLICANT:
I certify that all statements made in this application are true and correct and that any misstatement of
material facts may subject me to disqualification or dismissal. Also, I authorize verification of all statements
made in this application.

Signature: __________________________________________________ Date: ________________________

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