Job Application - Tidewater Oil

Equal access to programs, services and employment opportunities is available to all persons without regard to race, religion, color, sex (including pregnancy), age, national origin, mental or physical disability, sexual orientation, gender identity, genetic information, or any other basis protected by federal, state and/or local law. In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonable accommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonable accommodations include making a change to the application process; providing written materials in an alternate format such as braille, large print, or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions.

Personal Information

Name*

Address*

Phone*

Email*

Position(s) applied for*

Referral source*

(e.g., Walk-in, Job Posting, Company's Website, etc.)

Do you have a driver license?*

Yes
No

Have you ever pleaded "guilty" or "no contest" to or been convicted of a crime?*

Note: Answering "yes" to this question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account. You are not obligated to disclose juvenile records that have been expunged.

Yes
No

Please provide date(s) and details:*

Have you entered into an agreement with any former employer or other party (such as a noncompetition agreement) that might, in any way, restrict your ability to work for our company?*
Yes
No

Please explain:*

What is your desired salary range or hourly rate of pay?*

Will you work overtime if required?*
Yes
No

Employment History

Employer*

Address*

Email*

Starting job title / final job title*

Dates employed*

Summarize the type of work you performed.

Why did you leave?*

Immediate Supervisor name and title*

May we contact for reference?*
Yes
No

Add employer 2
Yes
No

Employer 2*

Address*

Email*

Starting job title / final job title*

Dates employed*

Summarize the type of work you performed.

Why did you leave?*

Immediate Supervisor name and title*

May we contact for reference?*
Yes
No

Add employer 3
Yes
No

Employer 3*

Address*

Email*

Starting job title / final job title*

Dates employed*

Summarize the type of work you performed.

Why did you leave?*

Immediate Supervisor name and title*

May we contact for reference?*
Yes
No

Have you ever been fired or asked to resign from a job?*
Yes
No

Please explain*

Licenses

Summarize any special training, skills, languages, licenses, and/or certificates that may assist you in performing the position for which you are applying.

Related Information

Is there any other job-related information you want us to know about you?

Attachments

Cover Letter

Resume

References

Applicant Statement

Consent*
I understand*
I certify that all information I have provided in order to apply for and secure work with this employer is true, and correct.

I expressly authorize, without reservation, the employer, its representatives, employees, or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities, and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees, or representatives, for seeking, gathering, and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations, or organizations for furnishing such information about me.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state, or federal law.

I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without case and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provided proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I understand that reasonable safeguards will be taken to protect all personal information provided or obtained in conjunction with this application for employment. My personal information may be shared with the employer's affiliate(s) and third parties engaged by the employer to perform services for the employer. Any personal information shared with an affiliate or third party is to be used to perform the services requested by the employer.

This Company does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her race, religion, color, sex (including pregnancy), age, national origin, mental or physical disability, sexual orientation, gender identity, genetic information, or any other protected status under applicable federal, state, or local law.

I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer's service, whenever it is discovered.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.
I certify that I have read, fully understand and accept all terms of the foregoing Applicant System.

Signature of Applicant*

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