Form For Employment
A Drug Free Workplace
An Equal Opportunity Employer

NELLA Oil Company Flyers - The New Name for ConvenienceOlympian

Name (Last, First Middle):

E-Mail Address:

Phone Number:

Present Address:

Position Applied For:

Referred By:

Names Of Friends or Relatives Employed by This Company:

 

Are you wiling to work nights and weekends?

Yes No

Are you over 18?

Yes No

Are you employed now?

Yes No

Have you ever worked for the Company before?

Yes No

Do you have any gasoline tanker experience?

Yes No

If hired, do you have a reliable means of transportation?

Yes No

Can you, upon employment, submit verification of your legal right to work in this country?

Yes No

Has your drivers license ever been suspended?

Yes No

Number of traffic citations in last 5 years

Number of traffic accidents in last 5 years

Have you ever been convicted of a crime? (In answering this question, do not include convictions in excess of two (2) yearsold relating to possession or use of an ounce or less of marijuana, nor any misdemeanor conviction for which probation has been completed. Note: a conviction will not necessarily disqualify you from the postition applied for.)

Yes No
If yes, please explain in the area below.

 
 

Education: Name of last school attended:

 
 

Previous Work History (list 4):
 1 2

Employer:
Employment Dates: to
Position:
Responsibilities:
Salary:
Reason for Leaving:

Employer:
Employment Dates: to
Position:
Responsibilities:
Salary:
Reason for Leaving:

 3 4

Employer:
Employment Dates: to
Position:
Responsibilities:
Salary:
Reason for Leaving:

Employer:
Employment Dates: to
Position:
Responsibilities:
Salary:
Reason for Leaving:

 

Are you able to perform all essential functions of the job for which you are applying?

Yes No
If no, explain below.

Are you able to perform all other duties of the job for which you are applying?

Yes No
If no, explain below.

The area below is provided for you to explain anything regarding the above questions.

back