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Posi Ti On (S) Applyi NG For Personal I Nformation

This document is an application form for employment with Patterson-UTI Drilling. It requests personal information such as name, address, contact details, driver's license and transportation availability. It also asks for work experience history including positions held and previous employers' contact information. Finally, it requires a signature to authorize Patterson-UTI Drilling to use the information for hiring purposes and contact references.

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Dakota Clarkson
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
42 views

Posi Ti On (S) Applyi NG For Personal I Nformation

This document is an application form for employment with Patterson-UTI Drilling. It requests personal information such as name, address, contact details, driver's license and transportation availability. It also asks for work experience history including positions held and previous employers' contact information. Finally, it requires a signature to authorize Patterson-UTI Drilling to use the information for hiring purposes and contact references.

Uploaded by

Dakota Clarkson
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FORM for employment with Patterson-UTI Drilling.

(print clearly and complete in full)

POSI TI ON( S) APPLYI NG FOR


Personal I nformation

Legal Name:_____________________________________________________________________________________
Last First Initial
Mailing Address:__________________________________________________________________________________
City/Town Province
Home Phone:________________________________________ Alternate#________________________________

Do you have reliable transportation to and from work? (optional) Yes No


Valid Driver’s License: (optional) Yes No
Coverall Size:
Are you legally able to work in Canada? Yes No

How did you hear about us? ________________________________________

Emergency Contact

Name: ___________________________ Relationship: __________________________ Phone: _______________________________

Work Experience

Rig Manager _________ Yrs________Mo’s Driller _________ Yrs________Mo’s

Derrickman _________ Yrs________Mo’s Motorman _________ Yrs________Mo’s

Floorhand _________ Yrs________Mo’s Leasehand _________ Yrs________Mo’s

Type of Rig: Size of Rig:

Previous Employers

Were you previously employed by Patterson-UTI Drilling (formerly Phelps Drilling)? Yes No

Name: _________________________________________ ______________________________________________

Position: _________________________________________ ______________________________________________

Phone Number: ____________________________________ ______________________________________________


Length of
Service: _________________________________________ ______________________________________________

Valid Certificates

Are you enrolled in a Rig Technician Apprenticeship Program? Yes No


If yes, what level have you completed?

 Floorhand Training Date Completed:  Confined Space Expiry:


 First Aid Expiry:  Fall Protection Expiry:
 Loader Certificate Expiry:  Rig Rescue Expiry:
 Boilers Expiry:  TDG Expiry:
 st
1 Line Expiry:  H2S Expiry:
Certificate #: Certificate #:
 2nd Line Expiry:  WHMIS Expiry:
I certify that all information contained in this application is true, complete and accurate. I understand that providing false
information may result in no offer of employment or immediate dismissal.

I understand I will be on probation for the first three calendar months of my employment. At any time during this period,
if Patterson-UTI Drilling deems it appropriate to terminate my employment for any reason, there is no obligation to pay
severance pay.

I authorize Patterson-UTI Drilling to use this information, at their sole discretion, within the limits of the law. I also
authorize Patterson-UTI Drilling to contact either my present or previous employers for references.

I understand that any offer of employment made by Patterson-UTI Drilling is conditional upon a satisfactory, job-related
medical assessment and drug screen. I also understand the occupational requirements and certify that I am able to
perform any physical requirements of the positions’ duties.

Submitting this form confirms your consent to the collection, retention, use and disclosure of your personal
information and work history as required for job selection, placement, training, payroll, and work bids for which you may
be considered. Your information will be kept on file for the Company’s reference should you be considered for other
employment with Patterson-UTI Drilling.

The job/position you are applying for is seasonal and/or based on specific projects. Section 55 of the Alberta Employment
Standards Code authorizes an employer to terminate employment without notice at the completion of the drilling season
or the completion of the well for which you are being hired.

Signature

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