NextGen Energy Service, LLC

Job Application

Please complete the form below to apply for a position with us.
All positions will require you to be able to lift 50lbs or more and be able to stand for long periods of time.
Personal
Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*
Valid I.D. / Drivers License (Front & Back)*

Cancelof
Position Information
Position Applied
How did you hear about us
Available Start Date*

MonthDayYear
Salary Desired*
Check all that you are willing to work.
Hours*

Full-TimeDaysPart-TimeEvenings
SwingWeekendsGraveyard
Status*

RegularTemporary
Are you authorized to work in the U.S. on an unrestricted basis?*

YESNO
Have you every been convicted on a felony? (Convictions will not necessarily disqualify an applicant.)*

YESNO
Have you been told the essential functions of the job or have you viewed a copy of the job description listing the essential functions of the job?*

YESNO
Can you perform these essential functions with or without reasonable accommodations?*

YESNO
Qualifications

Please list any education and training you feel relate to the position applied for that would help you perform the work, such as schools. colleges, degrees, vocational or technical programs, and military training.
List School Name, Degree / Certifications, & Address
Special Skills: List any skills or experience that you feel would help you in the position that you are applying for.
Upload any education and training certifications.

Cancelof
References

Please list 3 professional references not related to you, with Full Name, Address, Phone Number, and Relationship.
Name - Address - Phone Number - Relation*
Work History

Start with present or most recent employment and work back. (include paid and unpaid)

Present / Most Recent

	Please fill In
Company Name & Job Title
Start - End Dates (m/d/y)
Supervisors Name & Phone Number
Company Address
Starting Salary
Ending Salary
Reason for Leaving
May we contact?

2nd Most Recent

	Please fill In
Company Name & Job Title
Start - End Dates (m/d/y)
Supervisors Name & Phone Number
Company Address
Starting Salary
Ending Salary
Reason for Leaving
May we contact?

3rd Most Recent

	Please fill In
Company Name & Job Title
Start - End Dates (m/d/y)
Supervisors Name & Phone Number
Company Address
Starting Salary
Ending Salary
Reason for Leaving
May we contact?

4th Most Recent

	Please fill In
Company Name & Job Title
Start - End Dates (m/d/y)
Supervisors Name & Phone Number
Company Address
Starting Salary
Ending Salary
Reason for Leaving
May we contact?

Please read and sign.
I certify that the facts set forth in this Job Application are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize NextGen Energy Service, LLC to make an investigation of any of the facts set forth in this application and release NextGen Energy Service, LLC from any liability. NextGen Energy Service, LLC may contact any listed references on the application.

I acknowledge and understand that the company is an "at will" employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the emplower may terminate the employment relationship at any time, with or without cause, with or without notice to the other party.
Signature*

Powered by Jotform SignClear
Should be Empty:

Job Application

Personal

Position Information

Check all that you are willing to work.

Qualifications

References

Work History

Please read and sign.