Employment

Blank Form (#3)

Employment Application

Agree that I have read and understand the terms listed above.

Yes

Name

Address

Street/Apartment

City

State

Zip Code

Country

Phone Number

Date Available

Position Applied For:

Are you a citizen of the United States?

Yes

If no, are you authorized to work in the US?

Yes

Have you ever worked for this company?

Yes

If so, when?

Have you ever been convicted of a felony?

Yes

If yes, explain:

Education

Name of high school

Address of high school

Years Attended (To - From)

Name of college

Address of college

Years Attended (To - From)

References

Reference #1 Full Name

Company Name

Address

Phone Number

Relationship

Reference #2 Full Name

Company Name

Address

Phone Number

Relationship

Employment History

Company #1

Job Title

Supervisor

Address

Phone Number

Time Worked (From - To)

Responsibilities

Reason for Leaving

Company #2

Job Title

Supervisor

Address

Phone Number

Time Worked (From - To)

Responsibilities

Reason for Leaving

Military

Service Branch

Years Served (From - To)

Type of Discharge

If other than honorable, explain:

Disclaimer and Signature:

I Agree

Drug testing is a requirement prior to employment. By checking "I Agree" on this application you are authorizing B&G Pipeline your permission to provide a pre-employment drug test. You also certify that your answers are true and complete to the best of your knowledge. B&G Pipeline Company will do a background check to verify all information. By agreeing to this you are authorizing B&G Pipeline your permission to verify any and all information provided. If this appliction leads to employment, I understand that false or misleading information in my application or interview may result in my immediate release.

Verification

Please enter any two digits

Email Address

Safety Precautions

What You Need to Know Before Filling out this Application

Employment Application

Education

References

Employment History

Military

Verification