Employment

Your Name:

Date of Birth:

Your SSN:

Phone Number:

Email Address:

Home Address:

Do you have a valid driver’s license?
YesNo

Do you have a CDL?
YesNo

DL#:

Have you been convicted of a felony?:
YesNo

Are you legal to work in the United States?
YesNo

What position are you qualified for?

List the past three companies you worked for:

Are you currently employed?
YesNo

Can we contact your present employer?
YesNo

Who do you currently work for?

Desired Pay:

Describe any relevant work experience you have:

What Certificates, Training, and other relevant experience would you bring to Maxon Drilling, LLC?

References required:

How did you hear about us hiring:

 
Employment History:
All drivers and other applicants are required to provide the following information on all employers during the preceding three (3) years.
In addition, all drivers are required to provide an additional seven (7) years of information on those employers for whom you operated commercial motor vehicles. Please complete the following page with all information. Fill out the third sheet of this application completely, we need valid phone numbers to perform required previous employment verifications as required by policy and/or by Federal Motor Carrier Regulations.
**Your application will be rejected if not completed properly as requested with phone numbers.

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PLEASE READ THE INSTRUCTIONS
Previous Employers Information, past three years; **List the Most Current Employer First**
In addition, applicants that are preparing to drive a commercial motor vehicle in instrastate or interstate commerce shall provide an additional seven (7) year history of former employers for whom you operated a commercial motor vehicle. Fail to properly complete this page will result in application being rejected.
-Must have address and phone number-
Previous Employer-Start with most Current

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Employer #1 Name:

From:

To:

Pay:

Address:

City & State:

Zip Code:

Contact Person:

Phone Number:

Position Held:

Reason for leaving:

Was your job a safety sensitive function and require drug/alcohol testing?YesNo

Were you subject to Federal Motor Carrier Safety Regulations while employed?YesNo

Employer #2 Name:

From:

To:

Pay:

Address:

City & State:

Zip Code:

Contact Person:

Phone Number:

Position Held:

Reason for leaving:

Was your job a safety sensitive function and require drug/alcohol testing?YesNo

Were you subject to Federal Motor Carrier Safety Regulations while employed?YesNo

Employer #3 Name:

From:

To:

Pay:

Address:

City & State:

Zip Code:

Contact Person:

Phone Number:

Position Held:

Reason for leaving:

Was your job a safety sensitive function and require drug/alcohol testing?YesNo

Were you subject to Federal Motor Carrier Safety Regulations while employed?YesNo