
Online Job Application
If you wish to be considered for a position, please complete and submit the following
job application form.
First Name:
Last :
Date of Birth:
Sex:
female
Social Security #:
Email Address:
Phone Number (main number):
Additional Phone Number(s) (Optional):
Please list personal references of non-family members who can vouch for your character:
Name of first reference:
Address of first reference:
Name of second reference:
Address of second reference:
Have you ever applied to this
company before?
yes
no
If yes, when?
Have you ever worked for this
company before?
yes
no
If yes, what was your reason for leaving?
Has an employee of Cajun Well Service referred you for employment?
yes
no
If yes, who?
Are you seeking full-time employment?
yes
no
If yes, are you willing to work overtime?
yes
no
Do you have dependable transportation?
yes
no
Do you have a valid driver's license?
yes
no
If yes, are you willing to operate a company vehicle?
yes
no
If yes, do you grant Cajun Well Service permission to review your driving record?
yes, driving license #:
no
Have you ever worked on a well servicing/workover rig before?
yes
no
If yes, briefly describe the amount ot time spent and the position(s) held:
Do you have swabbing or hot oil experiece?
yes
no
If yes, briefly describe the amount ot time spent on the position(s) you have worked:
Have you ever been convicted of a felony?
yes
no
If yes, please explain:
List special skills or certifications such as mechanic, welder, painter, forkift operator, etc.:
Grade Level Completed:
Degree(s) Earned:
High School:
College:
Business/Trade School:
Military Service:
Years Served:
Are you currently serving?
yes
no
If yes, state explanation of time off needed for service or any other related comments.
Please list your last
three employers, starting with the most recent.
Present / Last Employer:
Phone Number:
Address:
City:
State:
Zip Code:
When were you employed?
From:
To:
Job Title:
Starting Salary:
Ending Salary:
Name of Supervisor:
Description of Work:
Reason for Leaving:
Previous Employer:
Phone Number:
Address:
City:
State:
Zip Code:
When were you employed?
From:
To:
Job Title:
Starting Salary:
Ending Salary:
Name of Supervisor:
Description of Work:
Reason for Leaving:
Previous Employer:
Phone Number:
Address:
City:
State:
Zip Code:
When were you employed?
From:
To:
Job Title:
Starting Salary:
Ending Salary:
Name of Supervisor:
Description of Work:
Reason for Leaving:
Authorization
“The information in this Application for Employment is true, correct, and complete. If employed by Cajun Well Service, any misstatement or omission of fact on this application may result in my dismissal.
I understand that acceptance of an offer of employment does not create a contractual obligation upon Cajun Well Service to continue to employ me in the future.
If Cajun Well Service decides to engage an investigative consumer reporting agency to report on my credit and personal history I authorize you to do so. If a report is obtained Cajun Well Service will provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report. ”
I agree.
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