P.O. Box 2463
Midland, TX. 79702

Office (432) 682-7168
Fax (432) 682-7199

Employment

First Name Last Name

Street Address
City State Zip Code

Home Phone
Other Phone

Email Address
 

Employment Desired

Locations (check all that apply) Positions (check all that apply)
Permian Basin
Fort Worth Basin 		Shop Technician
Logging Unit Rigger
Mudlogger
Office Staff

Start Date
Salary Desired
$ / hour

Are you currently employed?

May we contact your current employer?

Education

High School
School Name:
Dates Attended:
Did you graduate?

College
School Name:
Dates Attended:
Degree:
Did you graduate?

Special Skills and/or Training

Employment History (list last 3 employers starting with the most recent)

Employer:
Phone:
Dates:
Position:
Salary:
Reason for leaving:

Employer:
Phone:
Dates:
Position:
Salary:
Reason for leaving:

Employer:
Phone:
Dates:
Position:
Salary:
Reason for leaving:

References

Reference:
Phone:
Relationship:

Reference:
Phone:
Relationship:

Reference:
Phone:
Relationship: