Pioneer Oil Application for Employment

Application for Employment

Pioneer Oil Company, Inc.
This is a pre-employment questionnaire. Pioneer Oil Company, Inc is an equal opportunity employer.

Please fill out the form completely and we will contact you shortly.
Personal Information
Name*

First NameMiddle NameLast Name
Present Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permenant Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Are you 18 years or older?*

YesNo
Are you prevented from lawfully becoming employed in this country because of a visa or immigration status?*

YesNo

Employment Desired
Which company are you applying to work for?*
What position are you applying for?*
Date You Can Start Work*

MonthDayYear
Date
Salary Desired
Are you employed now?*

YesNo
If so, can we inquire of your present employer?*

YesNo
Have you ever applied to this company before?*

YesNo
If so, when?

Education
Grammar School*
Name & Location of School
Number of Years Attended*
Did you graduate?*

YesNo
Subjects Studied
High School
Name & Location of School
Number of Years Attended
Did you graduate?

YesNo
Subjects Studied
College
Name & Location of School
Number of Years Attended
Did you graduate?

YesNo
Subjects Studied
Trade Business or Correspondence School
Name & Location of School
Number of Years Attended
Did you graduate?

YesNo
Subjects Studied

Subjects of Special Study or Research Work
Special Skills
Activities: Civic, Athletic, etc.
Exclude organizations, the name of which indicates the race, creed, sex, age, marital status or nation of origin of its members.
US Military or Naval Service
Rank
Present Membership in National Guard or Reserves

Former Employers

List below the last three employer, starting with the most recent one first.
Employer #1: Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Salary
Position
Reason For Leaving
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Employer #2: Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Salary
Position
Reason For Leaving
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Employer #3: Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Salary
Position
Reason For Leaving
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Which of these jobs did you like the best? What did you like most about that job?
References

Give the names of three persons not related to you, whom you have known for at least one year.
Reference #1: Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business*
Years Acquainted*
Reference #2: Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business*
Years Acquainted*
Reference #3: Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business*
Years Acquainted*
Emergency Contact

In case of emergency, please add your emergency contact to notify.
Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Please upload document/s that proves the employment authorization

Browse Files

Cancelof
ACKNOWLEDGMENT & CONFIRMATION: EMPLOYER

I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT IF ANY FALSE INFORMATION OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED, MY APPLICATION MAY BE REJECTED AND, IF I AM EMPLOYED, MY EMPLOYMENT MAY BE TERMINATED AT ANYTIME.IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE COMPANY'S RULES AND REGULATION, AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT EITHER MY OR THE COMPANY'S OPTION. I ALSO UNDERSTAND AND AGREE THAT THE TERMS AND CONDITIONS OF MY EMPLOYMENT MAY BE CHANGED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, ANDANY TIME BY THE COMPANY. I UNDERSTAND THAT NO COMPANY REPRESENTATIVE, OTHER THAN ITS PRESIDENT, AND THEN ONLY WHEN IN WRITING AND SIGNED BY THE PRESIDENT, HAS ANY AUTHORITY OR ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIC PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING.'
Employer's Signature or Authorized Representative

Powered by Jotform SignClear
Date Signed

MonthDayYear
Date
Should be Empty:

Application for Employment

Personal Information

Employment Desired

Education

Former Employers

References

Emergency Contact