Office Administrator Application

Employment Application

In accordance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, region, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
TO BE READ AND SIGNED BY APPLICANT

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company.

I understand that information I provide regarding current and/or previous employer may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e).

I understand I have the right to:
• Review information provided by previous employer(s)
• Have errors in the information corrected by previous employer(s) and for those previous employer(s) to re-send the corrected information to the prospective employer
• Have a rebuttal statement attached to the alleged erroneous information that I, and the previous employer(s) cannot agree on the accuracy of the information.
Please Provide Your First And Last Name

First NameLast Name
Last 4 Of Social
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

I acknowledge this is a local job in Williston North Dakota and not rotational. I live here in Williston North Dakota. (Please type yes in the box below)
Your Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please Upload A Copy Of Your Drivers License

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Where You Referred To Us? If So By Who?
Have You Applied At Anchors Before? If So When?

Job History

Please list at least 3 to 5 years of Job history especially if it's relative to the current position you're applying for. Please list your most recent job first.
Current/Recent Job
Dates Employed (MM/DD/YYYY) to (MM/DD/YYY)
Position/Title Held
Supervisors Name and Number
Currently Employed If Not, Reason For Leaving
May We Contact?
List your Duties-
Company Name
Dates Employed (MM/DD/YYYY) to (MM/DD/YYY)
Position/Title Held
Supervisors Name and Number
Reason For Leaving
May We Contact?
List your Duties-
Company Name
Dates Employed (MM/DD/YYYY) to (MM/DD/YYY)
Position/Title Held
Supervisors Name and Number
Reason For Leaving
May We Contact?
List your Duties-

Company Name
Dates Employed (MM/DD/YYYY) to (MM/DD/YYY)
Position/Title Held
Supervisors Name and Number
Reason For Leaving
May We Contact?
List your Duties-
Company Name
Dates Employed (MM/DD/YYYY) to (MM/DD/YYY)
Position/Title Held
Supervisors Name and Number
Reason For Leaving
May We Contact?
List your Duties-
Please Upload Your Resume if needed

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Please list skills and any certifications that would be beneficial for this position.

Please List 3 Personal References

Rows	First and Last Name	Phone Number	Years Known
Personal Reference 1
Personal Reference 2
Personal Reference 3

Please List 3 Professional References

Rows	First and Last Name	Phone Number	Years Known
Professional Reference 1
Professional Reference 2
Professional Reference 3

Should be Empty:

Employment Application

Job History