Work for Fickler Oil Company

Applicant Information

Applicant Name

Date of Application

Street Address

City, State Zip

Phone Number

Employment Position

Position Applying For

How did you hear about this position?

What hours or shift are you available for work?

What date can you start working if you are hired?

Do you have reliable transportation to and from work?

Salary Desired?

Personal Information

Have you ever applied to or worked for Fickler Oil Company, Inc before? If so, when?

Do you have any friends, relatives, or acquaintances working for Fickler Oil Company, Inc? If so, state name and relationship.

Are you 18 years of age or older? Yes No

Are you a U.S. citizen or approved to work in the United States? Yes No

What document can you provide as proof of citizenship or legal status?

Do you have any condition which would require job accommodations? If so, please describe accommodations required.

Job Skills/Qualifications

Please list below the skills and qualifications you possess for the position for which you are applying: Note: Fickler Oil Company, Inc complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applications/employees to perform essential functions.

Education and Training

HIGH SCHOOL

Name

Location (City, State)

Year Graduated

Degree Earned

COLLEGE/UNIVERSITY

Name

Location (City, State)

Year Graduated

Degree Earned

VOCATIONAL SCHOOL/
SPECIALIZED TRAINING

Name

Location (City, State)

Year Graduated

Degree Earned

MILITARY:

Are you a member of the Armed Services? Yes No

What branch of the military did you enlist?

What was your military rank when discharged?

How many years did you serve in the military?

What military skills do you possess that would be an asset for this position?

Previous Employment

Employer Name

Job Title

Supervisor Name

Employer Address

City, State Zip

Employer Phone

Dates Employed

Reason for Leaving

Employer Name

Job Title

Supervisor Name

Employer Address

City, State Zip

Employer Phone

Dates Employed

Reason for Leaving

Employer Name

Job Title

Supervisor Name

Employer Address

City, State Zip

Employer Phone

Dates Employed

Reason for Leaving

References

Reference Name

Contact Information

Reference Name

Contact Information

Reference Name

Contact Information

At-Will Employment

The relationship between you and the Fickler Oil Company, Inc is referrred to as "employment at will." This means that your employment can be terminated at any time for any reason, wiith or without cause, with or without notice, by you or the Fickler Oil Company, Inc. No representative of Fickler Oil Company, Inc has authority to enter into any agreement contray to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowlede that no oral or written statement or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Exectutive Vice-President/Chief Operations Officer or the Company's President.

← Check this box if you have read and agree to the At-Will Employment statement.

Job Application

Applicant Information

Employment Position

Personal Information

Job Skills/Qualifications

Education and Training

Previous Employment

References

At-Will Employment