Atlantis Petroleum LLC                                        

Employment Application       

 

Position Applied For                                                                     Location                                     Date_______

 

Print Name: ________________________________________________________________________________                                                                                                                               

Other Names Used (for purpose of checking references) _____________________________________________

 

Present Address:  Street                                                           City                                      State        Zip _____ How Long?                                                                      Telephone Number (      )_______________________                                                             

Previous Address:  Street                                                         City                                      State         Zip _____

 

Social Security Number ________________________                                                                   

 

Referral Source: Advertisement        Friend             Atlantis Employee              Walk-In               Other _________

 

If you are under 18 years of age, can you furnish a work permit if you are offered a position? Yes              No ____   

 

Have you applied for work here before?  Yes           No                If Yes, Date Applied ______________________

 

Have you ever been employed by ATLANTIS PETROLEUM?                        Yes        No____        

If Yes, Date ___________       Position/Location ______________________ Reason for Leaving ______________

 

Are you currently employed?   Yes       No       If Yes, May we contact your present employer?   Yes           No ___  

 

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? 

Yes              No                       (Proof of Citizenship or Immigration Status will be required upon employment)

 

Date available for active work:   _______________                                      

 

Are you available to work   Full-Time                Part-Time                Seasonal   ____      

 

Are you on a Lay-Off and subject to recall?    Yes     __No___          

 

Have you ever been convicted of a felony?     Yes         No___               

If yes, please explain: ________________________________________________________________________

Failure to answer this truthfully may result in termination.  Conviction will not necessarily disqualify applicant from employment.  The nature of the offense, date, and the position applying for will all be considered. AMERICAN ENTERPRISE FUNDING LLC reserves the right to perform a criminal background check on all employees and applicants.

 

Veteran of U.S. Military Service?  Yes       No         Reserve Status: Active         Inactive        Branch_________        

EDUCATION

Name / Location of  School

Major Subject Studied

Graduated

Yes or No

Degree or Diploma

High School

 

 

 

Trade/Business

 

 

 

College

 

 

 

Other

 

 

 

 

 

EMPLOYMENT HISTORY

Start with your present or most recent job. Include military service assignments and periods of unemployment.

 

Employer                                                                                 Type of Business _______________________________          

Address                                                                                    Telephone __________  Job Title___________________         Starting Salary                        Present/Final Salary _______ Starting Date                  Ending Date    ______________

Job Duties ____________________________________________________________________________________________ Supervisor                                                         May We Contact?  Yes              No ______

Reason for Leaving _____________________________________________________________________________________

 

Employer                                                                                 Type of Business _______________________________          

Address                                                                                    Telephone __________ Job Title___________________          Starting Salary                        Present/Final Salary _______ Starting Date                 Ending Date    ______________

Job Duties ____________________________________________________________________________________________ Supervisor                                                         May We Contact?  Yes              No ______

Reason for Leaving _____________________________________________________________________________________

 

Employer                                                                                 Type of Business _______________________________          

Address                                                                                    Telephone __________ Job Title___________________          Starting Salary                        Present/Final Salary _______ Starting Date                 Ending Date    ______________

Job Duties ____________________________________________________________________________________________ Supervisor                                                         May We Contact?  Yes              No ______

Reason for Leaving _____________________________________________________________________________________

If you require additional space, please continue on a separate sheet of paper.

Acknowledgements:

·          I voluntarily authorize investigation into any and all statements contained in this application (and any accompanying resume or document).  I understand previous employers may be contacted for the purpose of investigation.  I authorize all personnel, schools, companies, corporations, credit bureaus and law enforcement agencies to supply any and all requested information and I will release the same from liability resulting from providing such information.

·          I understand ATLANTIS PETROLEUM occasionally be asked to submit/release certain information, including but not limited to my employment or application for employment.  I release the company and its agents from any liability for submitting/releasing such information.

·          I understand ATLANTIS PETROLEUM may request as a condition of an offer of employment or continuing employment that I undergo a medical exam and/or drug testing.  I agree to any such exam when required.  I understand that a satisfactory result in drug testing may be a condition of employment.

·          If employed, I agree to abide by the rules and regulations of the company, which may be changed at any time without prior notice to me.

·          I understand there is an introductory period of employment, during which time employment may be terminated without recourse.

·          I understand that if I am employed my employment is for no fixed term and is at-will.   I understand that I could be terminated at any time for any or no reason and I understand that I may quit at any time for any or no reason.  This understanding may not be altered, except in writing by an Executive of ATLANTIS PETROLEUM, such as President or CEO.

·          I understand this application and/or subsequent interview do not constitute an offer of employment; the application shall be active for a period of 45 days.

·          I am certifying that this was completed by me and the information is true and correct to the best of my knowledge. I understand that falsification of any information on this application may result in termination of employment for which I will hold ATLANTIS PETROLEUM blameless.

·          I understand overtime may be required as part of my job.

I have read and understand the above notice, including the at-will basis of employment.

 

Signature ______________________________________________________________                         Date __________                                      

ATLANTIS PETROLEUM is an equal opportunity employer.  Title VIII of the civil Rights Act of 1964, Executive Order

11246, the Age Discrimination in Employment Act of 1967, the Equal Pay Act of 1963, Section 503 of the Rehabilitation Act of 1973, and

the Americans with Disabilities Act of 1990 prohibit discrimination on the basis of race, color, sex, national origin, age or disability. 

 

            Equal Employment Opportunity. All employers are required by law to provide equal employment opportunity and may ask your national origin, race, and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no affect on your application for employment.

            Race:   ___White (Not of Hispanic Origin) ___Black (Not of Hispanic Origin) ___Hispanic

                         ___Asian or Pacific Islander            ___American Indian or Alaskan Native

 

            Sex:     ___ Male        ___Female