Online
Application
HOME OFFICE: 8 South 111th E. Ave | Tulsa, OK 74128 | (918) 742 7011 | FAX (918) 293-9358
TO THE APPLICANT: You must fully complete this application for it to be considered. Applications are active for ninety (90) days; thereafter, you must personally renew the application to be considered for employment.

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classification.

*This is not an official application. Another application must be filled out in person at our office before you are considered for hire.*

* Indicates A Required Field.
General Information:
Name: * E-mail Address: *
Mailing Address: *
City: * Telephone Number: *
State: * Zip: *
Cell Number: *
If hired, can you provide proof that you are eligible to work in the United States? Yes   No
Are you 18 or over? Yes   No * Do you have a valid drivers’ license? Yes   No *
 
Employment-Related Information:
Position Applying For: * Years Of Experience: *
Full-Time  |  Part-Time * Date you can start:
Are you willing to work weekends and/or overtime, if required? Yes   No
Are there any shifts or hours you cannot work? Yes   No   *
If “Yes,” when?
Are you willing to travel? Yes   No
Are you willing to relocate? Yes   No
Have you ever applied to or worked for this company before? Yes   No *
If “Yes,” when?
 
Education and Training:
Select highest level of Education completed:
List any other education, training, special skills or certificates/licenses that you have acquired which relate to this job. *
List any machines or equipment that you are qualified or experienced to operate. *
 
Former Employers: (List below your last three employers, starting with your present or most recent employer first.) *
Employer: Address:
City: State:
Zip: Phone:
Job Title: Supervisor:
Reason For Leaving:
Work Performed:
Dates Employed: Hourly Rate/Salary:
From: (mm/dd/yy)    To: (mm/dd/yy) Start:      Final:
 
Employer: Address:
City: State:
Zip: Phone:
Job Title: Supervisor:
Reason For Leaving:
Work Performed:
Dates Employed: Hourly Rate/Salary:
From: (mm/dd/yy)    To: (mm/dd/yy) Start:      Final:
 
Employer: Address:
City: State:
Zip: Phone:
Job Title: Supervisor:
Reason For Leaving:
Work Performed:
Dates Employed: Hourly Rate/Salary:
From: (mm/dd/yy)    To: (mm/dd/yy) Start:      Final:
 
If currently employed, may we contact your employer? Yes   No *
May we contact your previous employers? Yes   No *
Are you presently on lay-off status? Yes   No *
I acknowledge that the information I have provided is true to the best of my knowledge, and I authorize investigation of this information as may be necessary. Any misrepresentation or falsification of information, or significant omission, will be cause for rejection of my application, or for subsequent discipline up to and including termination of employment if discovered at a later date. I understand that I may be required to submit to a pre-employment physical and/or drug and alcohol screening analysis. The results of such analysis may be grounds for disqualifying me or terminating my employment. If employed, I understand that I will be an employee “at will” and that either M. L. Jones or I may terminate my employment relationship at any time, with or without cause or notice, for any reason which does not violate the law.
Agree To Terms & Conditions Mentioned Above: Yes No *