First Name:           
       Middle Name:       
       Last Name:           

       Phone Number:
       Mailing Address:
       Street Address:
       eMail Address:

       Do you have a Valid Oklahoma Drivers License?       
       What is your drivers license number:                       

       Where did you hear about our company?
      
       Are you eligible to work in the United States?       
       How old are you now?       
       If under age 18, do you have an employment/age certificates?       

       Have you been convicted of or pleaded no contest to a felony within the last five years?       
       If yes, please explain:
      


       POSITION/AVAILABILITY:

       Position Applied For:       
       What Days Are You Available For Work?       
       What Hours Are you Available For Work? From / To       
       What date are you available to start work?       


       EDUCATION:

       Name and Address Of School - Degree/Diploma - Graduation Date
      
       Skills and Qualifications: Licenses, Skills, Training, Awards
      


       EMPLOYMENT HISTORY:

       Employer Name:       
       Address:       
       Supervisor:       
       Phone:       
       Email:       
       Your Position Title:       
       Employed From: / To:       
       Your Responsibilities:       
       Salary:       
       Reason for Leaving:       


       Previous Employer


       Employer Name:       
       Address:       
       Supervisor:       
       Phone:       
       Email:       
       Your Position Title:       
       Employed From: / To:       
       Your Responsibilities:       
       Salary:       
       Reason for Leaving:       


       May We Contact Your Present /Past Employer? Yes or No       


       Five(5)References NOT family Members:
       Name, Phone, Address, City, State, Zip Code
      

       I certify that information contained in this application is true and complete.

       I understand that false information may be grounds for not hiring me or for
       immediate termination of employment at any point in the future if I am hired.

       I authorize the verification of any or all information listed above.

       First, Last Name:
      
       Date: