FESCO Employment Application

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APPLICATION FOR EMPLOYMENT

(Please type or print plainly in black ink.)

FESCO, Ltd.

PERSONAL

Date: 07/25/2014

Name

Last Name

Present Mailing Address:

Street or P.O. Box

Telephone No.

(

xxx-xxx-xxxx)

First Name

City

Cell Phone No.

(

Middle Initial

State

Zip Code

xxx-xxx-xxxx)

Positions Applied For 1. 2. 3.

Expected Pay Rate: $ Expected Pay Rate: $ Expected Pay Rate: $

per Hour per Hour per Hour

How did you learn of this opening?

Do you want to work: Full-Time

If Part Time (specify days and hrs)

Have you filed an application or been employed here before? N/A If YES, when?

Would you be willing to relocate to another FESCO District Office?

List any relatives or friends working for FESCO

If hired, on what date would you be available for work?

EDUCATIONAL BACKGROUND

School Type

Name and Address

High School College Post-Graduate Business Trade Other Other

Overall GPA

Years Attended

Graduated ?

N/A N/A N/A N/A N/A N/A N/A

Course or Major

An Equal Opportunity Employer

FESCO Application Form: Revised 0-200

Page 1 of 6

Have you ever served in the US Armed Forces? No

If yes, which branch? N/A

Duty Dates: From

To

Rank at discharge:

Describe you military service duties (include special training and duty stations):

Are you over 18 years of age? Yes

Do you currently use illegal drugs? No

Are you legally eligible for employment in this country? Yes

Have you ever been denied a license permit or privilege to operate a motor vehicle? No Has any license permit or privilege ever been suspended or revoked? No

(If the answer to either of the above two questions is YES, attach a separate statement giving details.)

Have you attended a "Defensive Driving Course"? No

If yes, when?

Other than for minor traffic offenses, have you ever been 1) convicted of a misdemeanor or felony crime; 2) received a probated sentence (including deferred adjudication) or pretrial diversion for an alleged crime; 3) been assigned a probation officer; 4) pleaded guilty or no contest to an alleged crime?

No

If the above question is YES, explain the nature of each offense and include the date, city, and state:

Driver's License No.: State Issued: Expiration Date:

License Classification (Class C, Class A, etc.): Special Endorsements: Restrictions:

Can you drive a vehicle that contains a manual (standard or "stick") transmission? No

TRAFFIC CONVICTIONS AND FORTEITURES FOR THE PAST 3 YEARS (other than parking convictions) (NOTE: If hired for a position that requires driving a company vehicle, a copy of your driving record will be ordered.)

LOCATION

DATE

CHARGE

PENALTY

FESCO Application Form: Revised 06-2005

Page 2 of 6

EXPERIENCE AND QUALIFICATIONS ? FIELD or SHOP WORK

Equipment Operation and Check

Years of

Equipment, etc.

Check

Years of

Experience

Experience

Experience

Woodworking Equipment Sheet Metal Equipment Body Work Auto / Truck Repair Electric Welder

Oxy-Acetylene Welder

Paint Spray Gun Pipe Fitting

Hydraulic Wireline Units

BHP Equipment

Portable Separators Natural Gas Measurement Calibrations

Engineering Calculations Hydrocarbon

Analysis Carpentry

EXPERIENCE AND QUALIFICATIONS ? CLERICAL

Clerical Operation

Training

Years of

Software

Training

and Experience

(Check)

Experience

Proficiency

(Check)

Typing (words per minute)

Calculator

Microsoft Office Suite

Accounting

Group Insurance and Benefits Computerized Payroll

Years of Experience

(This must be filled out) EXPERIENCE AND QUALIFICATIONS - GENERAL

To help us find the proper position for you in our company, please summarize other skills, qualifications and experiences that you feel would benefit FESCO. Also, explain in your own words why you would make a good employee.

FESCO Application Form: Revised 06-2005

Page 3 of 6

PERSONAL REFERENCES

(excluding former employers or relatives)

Name and Occupation

Address

Home Phone Work Phone

PRIOR WORK HISTORY (List in descending date order, last or present employer first)

Engagement #1

From To Date Date

Employer Name and Address

per Hour

Start Pay Rate

End Pay Rate

Reason for Leaving

Supervisor Name

Describe in detail the work you performed.

Title

Phone No.

Cell Phone

Engagement #2

From To Date Date

Employer Name and Address

Supervisor Name

Describe in detail the work you performed.

Title

per Hour Start End Pay Pay Rate Rate

Phone No.

Reason for Leaving

Cell Phone

FESCO Application Form: Revised 06-2005

Page 4 of 6

Engagement #3

From To Date Date

Employer Name and Address

Supervisor Name

Describe in detail the work you performed.

Title

per Hour Start End Pay Pay Rate Rate

Phone No.

Reason for Leaving

Cell Phone

Engagement #4

From To Date Date

Employer Name and Address

Supervisor Name

Describe in detail the work you performed.

Title

per Hour Start End Pay Pay Rate Rate

Phone No.

Reason for Leaving

Cell Phone

Engagement #5

From To Date Date

Employer Name and Address

Supervisor Name

Describe in detail the work you performed.

Title

FESCO Application Form: Revised 06-2005

per Hour

Start Pay Rate

End Pay Rate

Phone No.

Reason for Leaving

Cell Phone

Page 5 of 6

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