Text Box: I hereby certify that this application has been read by me, and that the statements contained herein are true and correct.  Permission is hereby granted to any person, firm, or corporation, whether my former employer or not, to give Tobias Inc. full information pertaining to my working ability and character.  Please initial the box below and date:

Text Box: Initials:

Text Box: Date:

Text Box: Position Applying for:

Text Box: Your Name:

Text Box: Current Street Address:

Text Box: City:

Text Box: State/Province:

Text Box: ZIP:

Text Box: Marital Status:

Text Box: Spouse’s Name:
(If NONE leave Blank)

Text Box: Spouse’s Employer:
 

Text Box: Date of Birth
(MM/DD/YY):

Text Box: SSN:

Text Box: Home Phone
(w/area code):

Text Box: Online Employment Application
(Complete each box below then click on the “SUBMIT” button at the bottom of this form to transmit your application)

Text Box: Emergency Contact:

Text Box: Emergency Contact
Relationship:

Text Box: Phone:

Text Box: Education:

Text Box: List any additional training or experience pertaining to the oilfield industry:

Text Box: Are you eligible for employment in the USA?

Text Box: Can you swim?

Text Box: Are you a smoker?

Text Box: Do you have your own transportation?

Text Box: If needed, are you willing to work over?

Text Box: Have you ever received workman’s compensation?

Text Box: Do you have a claim pending now against any company?

Text Box: If yes, please explain:

Text Box: Will you be willing to take a pre-employment drug screen and random drug screens during your employment with Tobias, Inc.?

Text Box: Will you be willing to abide by the safety rules of this company?

Text Box: List all on-the-job accidents experienced by you in your work history.  Include the date of each accident and whether the accident was classified as a lost time accident:

Text Box: Have you ever been convicted of a criminal offense?

Text Box: If yes, give date, nature of conviction, & place of conviction:

Text Box: Employment History
(Give information on last 3 employers)

Text Box: Job #1
Text Box: Job #2
Text Box: Company Name:

Text Box: Supervisor:

Text Box: Address:

Text Box: City:

Text Box: Phone:

Text Box: Job Description:

Text Box: Reason for Leaving:

Text Box: Length of Employment:

Text Box: Company Name:

Text Box: Supervisor:

Text Box: Address:

Text Box: City:

Text Box: Phone::

Text Box: Job Description:

Text Box: Reason for Leaving:

Text Box: Length of Employment:

Text Box: Company Name:

Text Box: Supervisor:

Text Box: Address:

Text Box: City:

Text Box: Phone::

Text Box: Job Description:

Text Box: Reason for Leaving:

Text Box: Length of Employment:

Text Box: Job #3
Text Box: For problems with this web page, please email webmaster@tobiasonline.com.  
Copyright© 2009

Text Box: Back to Top