Personal Information
Last Name, First Name, Middle Initial
Email Address
Street Address, City, State, Zip Code
Phone Number
Have you been employed with Blue Quail Energy Services before? YesNo
Are you currently employed? YesNo
How did you hear of Blue Quail Energy Services? Newspaper AdCustomerInternet SiteBlue Quail EmployeeOther
What are your salary requirements?
Are you at least 18 years of age? YesNo
What hours can you work? Check all that apply. Full TimePart TimeDayEveningWeekendsOther
Are you legally authorized to work in the United States? Proof of citizenship or immigration status will be required upon hiring YesNo
Have you ever plead guilty to, been convicted of, or received deferred legal judgment for a criminal offense? YesNo
If yes, explain type of offense.
High School Education
Years Completed 1234
Diploma, Degree or Course of Study
Name of School AND Location
Business/Technical
College/University
Graduate/Professional
Describe any specialized skills, languages, training or certifications you have received.
Give any other information that might be helpful to us in considering your application.
Employment
Fill out this section completely, even if you have similar information on your resume. List current employer first.
Company Name
Address
Supervisor's Name
Position Held
Start Date
End Date
Ending Salary
Reason for Leaving
If still employed: May we contact your current employer? YesNo
Professional References
Please do not include relatives.
Name
Company Name & Address
Title/Occupation
Years Known
Agreement and Certification Submitting this application below constitutes full acceptance of this employment application in its entirety and certifies that the information provided herein is true and complete to the best of my knowledge. I give Blue Quail Energy Services permission to verify all statements contained herein concerning prior employment, education and personal references by contacting companies, institutions and persons named. If I am employed, I understand that if I have deliberately omitted or given false or misleading information in this application, my resume (if any) or interview(s) I may be discharged. If Blue Quail Energy Services accepts me for employment, I agree to abide by all company policies and practices during my employment. I hereby release from all liability all persons or entities supplying or collecting such information. If I am offered employment, I understand the offer is contingent on the outcome of any investigations or reference checks satisfactory to Blue Quail Energy Services. In accordance with Blue Quail Energy Services' policy to maintain a drug-free workplace, any offer of employment will be contingent upon an applicant submitting to a drug test and receiving a negative drug test result. Also, certain employees may be subject to drug testing throughout their employment. I hereby agree to drug testing required by Blue Quail Energy Services policy and release the company from any liability arising from such testing and/or the decisions made based on such testing. I understand that my employment is contingent on my successful compliance with all employment eligibility verification requirements of the Immigration Reform and Control Act of 1986. If I am employed, I understand that I will be required to sign agreements regarding secrecy of communications and inventions, discoveries, or developments that I make, discover, or develop during my employment at Blue Quail Energy Services. If I am employed, I understand that my employment is "at will" and for no definite period of time. Either Blue Quail Energy Services or I may terminate my employment at any time, with or without cause and with or without notice. I further understand that my employment is at will regardless of any statement made by a Blue Quail Energy Services agent or in a Blue Quail Energy Services policy, practice, handbook, program, or any other written or oral materials. I understand that no representative of Blue Quail Energy Services have the authority to make agreements with me concerning the length of my employment other than the President.
