Employment Application - Barnhart Bolt
Date
-
Month
-
Day
Year
Date
Which location are you interested in?
Odessa, TX
Midland, TX
Hobbs, NM
El Reno, OK
AP Office Odessa, TX
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
-
Month
-
Day
Year
Date
Have you been an employee of Barnhart Bolt in the past?
Yes
No
Did someone refer you to this position, and if so, who?
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Previous Employer 1
Previous Employer
Previous Employer Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Position
Why did you leave?
When did you work there? (Please give date ranges)
May we contact your previous supervisor for a reference?
Yes
No
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Previous Employer 2
Previous Employer
Previous Employer Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Position
Why did you leave?
When did you work there? (Please give date ranges)
May we contact your previous supervisor for a reference?
Yes
No
Back
Next
Previous Employer 3
Previous Employer
Previous Employer Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Position
Why did you leave?
When did you work there? (Please give date ranges)
May we contact your previous supervisor for a reference?
Yes
No
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Which position(s) are you interested in?
Desired salary
Do you have a valid state driver's license?
Yes
No
If so, what state?
Date you can start?
-
Month
-
Day
Year
Date
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First Reference
Name
Relationship
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Second Reference
Name
Relationship
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Third Reference
Name
Relationship
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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High School
Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Did you graduate?
Yes
No
Diploma or certification:
First College
Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Did you graduate?
Yes
No
Diploma or certification:
Second College
Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Did you graduate?
Yes
No
Diploma or certification:
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Please check all that apply.
You are 18 years of age or older?
Yes
No
You are a citizen of the United States.
Yes
No
You are not a citizen, but are authorized to work in the U.S.
Yes
No
Have you ever been convicted of a felony or misdemeanor? A conviction will not necessarily disqualify you from employment.
Yes
No
If yes, please explain. If no, please put N/A.
Are you currently on parole?
Yes
No
Do you have any pre-existing medical conditions?
Yes
No
If yes, please explain. If no, please put N/A.
Describe your work experience:
Military Service: Branch served, Dates of Service, Rank at Discharge, Type of Discharge; If other than honorable, please explain.
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Acknowledgement
I certify that I have fully and accurately answered all questions and have given all information requested in this application for employment, and I understand that any wrong or incomplete information on the form may disqualify me for further consideration for employment or, if discovered after I am hired, may be grounds for my immediate dismissal. I understand that all such information is subject to verification by Barnhart Bolt, and hereby give my consent to Barnhart Bolt to investigate my background and qualifications using any means, sources and outside investigators at its disposal. I agree to undergo any type of drug and/or alcohol testing that Barnhart Bolt may require at any time. Finally, I understand that submission of this application does not necessarily mean that I will be hired, and that if I am hired, my employment will be at will, and either I or Barnhart Bolt may terminate my employment at any time, with or without notice or reason.
Acknowledgement
Yes
No
Digital Signature - Please Type Your Name
Attach your cover letter here.
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