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First Name

Last Name

Mobile Phone

Home Phone

Date of Birth

Marital Status

Married
Single

Social Security Number

Driver's License Number

State

Address

City

State

Zip Code

Email Address

Educational History

High School Education

High School Attended

City & State

Years Attended?

Graduated?

Other Education

Other (Specify)

Course of Study

City & State

Years Attended?

Graduated?

Employment History

Please list your last three jobs.

Company 1 Name

Company Address

State Date

End Date

Company 2 Name

Company Address

Start Date

End Date

Company 3 Name

Company Address

Start Date

End Date

Personal References

Reference #1

Address

Phone Number

Reference #2

Address

Phone Number

Reference #3

Address

Phone Number

Message

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Terms & Conditions

The facts set forth in my application for employment are true and complete. I understand that if employed, any false statement on this application may result in my dismissal. I further understand that this application is not intended to be a contract of employment, nor does this application obligate the employer in any way. If the employer decides to employ me, I understand and agree that my employment is at-will and can be terminated by either party with or without notice, at any time, for any reason or no reason.

I understand, agree, and verify that: The information supplied, was submitted by myself, and all information is true and correct, to the best of my knowledge. I understand that false or misleading information given in my application and/or interview(s) will be considered as cause for possible dismissal and/or discharge. I also understand that I am to abide by all rules and regulations of the company. The company has my authorization to thoroughly investigate my work and personal history. I understand that information supplied by me, regarding my: Employment History, Education (including an authorization to release transcripts), Credit History, Criminal History, Medical and Professional Licensing, Motor Vehicle Record(s), Residence History, and References, will be utilized as part of the processing procedures. A background check will be conducted to verify the veracity of the information submitted and will be utilized to develop information concerning my character, general reputation, personal characteristics, and mode of living. I will hold no person liable for giving or receiving information in this investigation. I hereby authorize SentryLink LLC, an agent of PetroLog International, Inc., to make a thorough check of my past Employment, Education, and activities.
I release from liability all persons, officers, companies, and corporations supplying that information.
I release and indemnify PetroLog International, Inc. and SentryLink LLC against any liability that might result from making such background checks. A copy of this form is as valid as the original.

I have read and hereby accept these Terms of Use