Employment Application - Victory Energy

APPLICATION INFORMATION

Name*

First Last

Date*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

Position Applying For*

Date Available*

Desired Salary*

How were you referred to us?

Are you 18 years of age or older?*

Yes
No

(If no you may be required to provide authorization to work)

Are you legally eligible for employment in the United States?*

Yes
No

(For employment, documentation will be required to verify eligibility)

Have you ever worked for this company?*

Yes
No

If you answered "Yes" to the previous question, when?

Do you have any relatives who are current or former employees of this company?*

Yes
No

If you answered "Yes" to the previous question, who and when?

EDUCATION

HIGH SCHOOL

City, State

Did you graduate?

Yes
No

Focus of High School Studies

COLLEGE

City, State

Did you graduate?

Yes
No

Degree

OTHER

City, State

Did you graduate?

Yes
No

Degree

OTHER

City, State

Did you graduate?

Yes
No

Degree

PROFESSIONAL LICENSES / MEMBERSHIPS / CERTIFICATIONS

1. License / Registration / Certification

Number

Date Received

Expiration Date

Licensing Agency

2. License / Registration / Certification

Number

Date Received

Expiration Date

Licensing Agency

3. License / Registration / Certification

Number

Date Received

Expiration Date

Licensing Agency

SKILLS AND QUALIFICATIONS

Summarize training/skills that may qualify you for the opportunity for which you are applying.

ADDITIONAL INFORMATION

List additional information you would like us to consider.

PREVIOUS EMPLOYMENT

Starting with present/most recent employer.

1. Company

Phone

Supervisor

City, State

From:

To:

May we contact this Employer for a reference?

Yes
No

Job Title

Starting Salary ($)

Ending Salary ($)

Responsibilities

Reason For Leaving

2. Company

Phone

Supervisor

City, State

From:

To:

May we contact this Employer for a reference?

Yes
No

Job Title

Starting Salary ($)

Ending Salary ($)

Responsibilities

Reason For Leaving

3. Company

Phone

Supervisor

City, State

From:

To:

May we contact this Employer for a reference?

Yes
No

Job Title

Starting Salary ($)

Ending Salary ($)

Responsibilities

Reason For Leaving

REFERENCES

1. Name

Phone

Best Time to Call

Years Acquainted

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

2. Name

Phone

Best Time to Call

Years Acquainted

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

3. Name

Phone

Best Time to Call

Years Acquainted

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

RESUME UPLOAD

Please upload your Resume here: (MSWord or PDF Only)

Max. file size: 50 MB.