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Full
Name
Last
First
MI
Address
Street Address
Apt #
City
State
Zip
Phone
Email Address
Date
Available
Social Security
Desired Salary
Position
Applied for:
Location preference: Collinsville
Cushing
Are
you a citizen of the United States
Yes
No
If no, are you authorized
to work in the U.S.?
Yes
No
Have
you ever worked for this company?
Yes
No
If so, when
Have
you ever been convicted of a felony?
Yes
No
If yes, explain
High
School
Address
From
To
Did you graduate?
Yes
No
College
Address
From
To
Did you graduate?
Yes
No Degree
Other
Address
From
To
Did you graduate?
Yes
No Degree
Please list three professional
references
Full
Name
Relationship
Company
Phone
Full Name
Relationship
Company
Phone
Full Name
Relationship
Company
Phone
Full Name
Relationship
Company
Phone
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference
Yes
No
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference
Yes
No
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference
Yes
No
Branch
From
To
Rank at Discharge
Type of Discharge
If
other than honorable, explain
This
application will be considered incomplete if all questions are not
answered. I certify that my answers are true and complete
to the best of my knowledge. Submission of this application
gives my permission for Victory Energy Operations, LLC or through
their selected agent to conduct a full background check.
If
this application leads to employment, I understand that false or
misleading information in my application or interview may result
in my release.
Please check one
I agree and certify that this application is correct
I disagree and do not certify that this application is correct
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