pre-employment-application - Phoenix Pipelines

PHOENIX PIPELINES – Employment Application

3801 E Superior Avenue Phoenix, AZ 85040
Phone: 602.470.1576

WE E-VERIFY
APPLICANT INFORMATION:

• Equal Opportunity Employer
• Drug Free Workplace must pass Drug Test and Physical Exam

First Name (required)

Last Name (required)

Street Address (required)

City (required)

State (required)

Zip Code (required)

Phone One (required)

Phone Two

Your Email (required)

I AM AT LEAST 18 YEARS OF AGE*
If you answered no you're age-restricted per A.R.S. § 23-231
YESNO

Are you eligible to work in the United States?
YESNO

Have you been convicted of or pleaded no contest to a felony within the last ten years?
YESNO

If yes, please explain:

TYPE OF WORK:

What position are you applying for:

When would you be able to start:

Desired Hourly Wage:

Why are you interested in this job?:

What makes you a good fit for this job?:

What is the best way to contact you?:

EDUCATION:

School Name

Major Degree/Diploma

Graduation Date

Skills and Qualifications: Licenses, Skills, Training, Awards:

Any Additional Information we should know?:

EMPLOYMENT HISTORY:

Present Or Last Position 1:
Employer:

Location:

Phone:

Position Title:

Start of Employment:

End of Employment:

Responsibilities

How much was Hourly / Salary?:

Reason For Leaving

Previous Position 2:
Employer:

Location:

Phone:

Position Title:

Start of Employment:

End of Employment:

Responsibilities

How much was Hourly / Salary?:

Reason For Leaving

May We Contact Your Present Employer?

YesNoNot Applicable

QUALIFICATIONS, SKILLS, OR TRAINING

SKILLS, TRAINING, EDUCATION, EXPERIENCE
List any special skills, experience, or training that might qualify you for this position.

Licenses or Certifications
List any current licenses or certifications that you might have. Include expiration dates if you know them.

Special Considerations or Concerns
I would like Phoenix Pipelines to take the following into consideration when reviewing my application for employment. I understand that Arizona is a Right to Work State.

References (3) are mandatory and you can only put one family member.
Please include Name, Occupation, Relationship and Phone number for each.

How did you hear about this position?

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above given to Phoenix Pipelines.
Please check the box if you AGREE.
I AGREE