Oregon Application

Employment History

Please print legibly and complete all fields. Start with the most current employer first. Explain gaps in employment in the comments section.
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title
Name of Supervisor
May we contact them for a reference?

YesNo
Phone Number
Please enter a valid phone number.
Starting Date

MonthDayYear
Date
Ending Date

MonthDayYear
Date
List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company.
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title
Name of Supervisor
May we contact them for a reference?

YesNo
Phone Number
Please enter a valid phone number.
Starting Date

MonthDayYear
Date
Ending Date

MonthDayYear
Date
List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company.
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title
Name of Supervisor
May we contact them for a reference?

YesNo
Phone Number
Please enter a valid phone number.
Starting Date

MonthDayYear
Date
Ending Date

MonthDayYear
Date
List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company.

Educational Background
Highest Level of Education
Ex: High School Diploma, Bachelor's Degree, etc.
Name of School
Years Completed
Did you graduate?

YesNo
References

List the name and phone number of three businesses or references that are NOT related to you and are NOT previous supervisors.
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.

Additional Information

Your background and work history will be discussed with you if you are granted an interview.
Please read this over carefully and sign your application below.

I certify that my answers to the questions contained in this application are true and complete. I understand that providing false or misleading information is cause for rejection of this application or, if I have been hired, dismissal from employment. I grant permission to Yellow Jacket Drilling (“Company”) and/or its designee to investigate my background and contact the previous employers and references I have listed to provide any information that the Company or the former employer or reference deems appropriate.

I understand that if I am hired by the Company, my employment will be “at will,” meaning that both the Company and I will have the right to end the employment relationship at any time, with or without advance notice and for any lawful reason or no reason.

I understand I will need to pass a screening for drug usage before being hired by the Company.
Signature*

Clear
Date*

MonthDayYear
Date
Have you been convicted of a felony?

YesNo
If yes, describe in full; A conviction will not necessarily bar you from employment.
(Note to the applicant: In keeping with applicable law, you should not disclose conviction information involving records of juvenile, adult, or other convictions that have been ordered by a court to be sealed or expunged, unless disclosure is required by A.R.S. § 13-911. Additionally, you should not disclose records of juvenile, adult, or other arrests that have not resulted in convictions (including, but not limited to, those that have been ordered by a court to be sealed or expunged).
Signature

Clear
Name

First NameLast Name
Driver's License #
Driver's License State
Birth Date

MonthDayYear
Date
Social Security #
Gender

MaleFemalePrefer not to answer
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

EMPLOYMENT APPLICATION

Employment History

Educational Background

References

Additional Information