US JOB APPLICATION FORM

We are an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion and job status, without regard to race, color, religion, creed, sex, marital status, national origin, age, physical or mental disability.

PERSONAL INFORMATION

First Name *

Last Name *

Date of Application *

Street Address *

City *

State *

Zip *

Telephone *

Email *

GENERAL INFORMATION

Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation?

Have you been convicted of any crime(s) other than minor traffic violations during the past seven years? (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying.)

If yes, explain:

EDUCATION & TRAINING

Did you attend Highschool?

If yes, please select the last high school grade completed

Did you attend College or University?

If yes, please select the year of College or University completed

Did you attend any other School (Technical Vocation, Graduate etc.)

If yes, please select the year of College or University completed

SKILLS

Please list any skills you have that are appropriate for the position you are applying for: *

If required, will you work? Please select the options below

Rotating Shifts Weekends Overtime Holidays

Position applying for, be specific: *

Salary Requirements (identify per hour or per year)

INTERESTS / ACCOMPLISHMENTS: You may wish to list significant experience, interests & accomplishments gained while working as a volunteer or as a hobbyist that may be useful in the position (s) you are seeking. Names or organizations designating religion, race, etc. need not be mentioned.

Date you can start *

EMPLOYMENT HISTORY

Starting with your PRESENT or MOST RECENT EMPLOYER list in consecutive order ALL EMPLOYMENT for at least the past FOUR employers.

If currently employed, may we contact your employer? *

PRESENT OR MOST RECENT EMPLOYER

FULL NAME OF COMPANY *

PHONE# (incl. Area Code)

STREET ADDRESS

CITY

STATE

ZIP

NAME & TITLE OF YOUR SUPERVISOR

TITLE OF YOUR POSITION

LIST JOBS HELD, DUTIES PERFORMED, SKILLS USED, & PROMOTIONS WHILE EMPLOYED AT THIS COMPANY:

SALARY - BEGIN

SALARY - END

EMPLOYED FROM MONTH/YEAR

EMPLOYED TO MONTH/YEAR. If presently employed with the company please leave blank.

REASON FOR LEAVING:

ACKNOWLEDGEMENT

Do you agree with the Acknowledgement Statement Above. *

I Agree

Date of Acknowledgement *

CALGARY, ALBERTA

Corporate Office

Location

1150, 1122 – 4th Street SW
Calgary, Alberta T2R 1M1

phone

(403) 457-5456

EMAIL

ap-canada@whiteowl-services.com

FAX

Fax: (403) 453-2211

DICKINSON, NORTH DAKOTA

North Dakota District Office

Location

112 – 3rd Street West, Suite 300, Dickinson, North Dakota 58601

Mailing Address:

White Owl Energy Services (US) Inc. PO Box 1953
Dickinson, North Dakota 58602

phone

(701) 483-6747

FAX

(701) 483-6748

US Emergency Number

1 (877) 503-5963