MFA Oil Companyapplication for employment

One Ray Young Drive

Columbia, MO65201

Today’s Date:

PERSONAL INFORMATION

Last Name / First / Middle / Social Security No.
Current Street Address / How Long?
City, State, Zip / Home Phone / Cell Phone
Have you previously worked for MFA Oil Companyor any associated company? / YES / NO
If yes, indicate name while employed, dates employed and company location:
Name: / Dates Employed: / Location:
Are you related to or acquainted with anyone now employed by MFA Oil Company or any associated company? / YES / NO
If yes, indicate name, relationship and company location where employed:
Name: / Relationship: / Location:
Who referred you to MFA Oil Company? / Is this person a current employee? / YES / NO
For what position are you applying? / Location Preference:
Date available for employment: / Length of time you plan to work: / Salary Expected: / $ / Per
Are you at least 18 years old? / YES / NO / Are you a U.S. citizen or otherwise authorized to work in the U.S.? / YES / NO
Have you ever been convicted of, pled guilty to, nolo contendre or no contest to, or otherwise been found guilty of any crime (including a suspended imposition of sentence)? / YES / NO
If yes, please explain:

Education

Check last
year completed: / Grade, Trade or High School
1 2 3 4 5 6 7 8 9 10 1112 / Technical, BusinessSchool or College
1 2 3 4 5 / GraduateSchool
1 2 3 4
High School Name / Location / Did you graduate? / YES / NO / GPA
List every Business or Trade School or College attended / Location / Dates Attended
(From-To) / Did you graduate? / Date of graduation / College
Major / Degree
Received / GPA
If you did not graduate from college, how many total college hours have you completed?
Do you have additional education plans? / YES / NO / If yes, please explain:

SKILLS

Please list any special qualifications, training, skills, business equipment operating abilities or experience that you feel might be useful on the job for which you are applying:

All potential employees are evaluated without regard to race, color, religion, gender, national origin, age, marital or veteran status, the presence of a non-job related handicap or any other legally protected status.

Employment history

List your experience below beginning with your present or most recent position.
1. Last or Present Employer / Job Title / Date Started
(Mo./Yr.) / Date Ended
(Mo./Yr.)
Address, City, State, Zip
Supervisor / Phone / Salary / $ / Per
Describe specific duties: / Reason for leaving or wanting to change jobs:
If we contact this employer, would you expect them to say they would rehire you? / YES / NO
2. Previous Employer / Job Title / Date Started
(Mo./Yr.) / Date Ended
(Mo./Yr.)
Address, City, State, Zip
Supervisor / Phone / Salary / $ / Per
Describe specific duties: / Reason for leaving or wanting to change jobs:
If we contact this employer, would you expect them to say they would rehire you? / YES / NO
3. Previous Employer / Job Title / Date Started
(Mo./Yr.) / Date Ended
(Mo./Yr.)
Address, City, State, Zip
Supervisor / Phone / Salary / $ / Per
Describe specific duties: / Reason for leaving or wanting to change jobs:
If we contact this employer, would you expect them to say they would rehire you? / YES / NO
Have you ever been involuntarily terminated or asked to resign from any position of employment? / YES / NO
If yes, please describe the circumstances:

References

Name & Address / Years Acquainted / Phone Number

Signature (Read carefully before signing)

I certify that the answers given herein are true and complete to the best of my knowledge.
I authorize investigations of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I authorize my former employers and any other persons or organizations to provide any information they have about me or my background, and I release all concerned from any liability in connection therewith.
In the event of employment, I understand that any false or misleading information given in my application or interview(s) may result in my discharge at any time. I also understand that I am required to abide by all rules, regulations and policies of MFA Oil Company.
I understand that MFA Oil Company may, as part of their normal pre-employment procedure, require a criminal background check, drug screen and motor vehicle report. By signing this application, I authorize MFA Oil Company to conduct these investigations.
I understand that, if hired by MFA Oil Company, my employment is at will and may be severed by either party at any time with or without cause, and with or without notice. I understand that neither this document nor an offer of employment from MFA Oil Company constitute an employment contract unless a specific document to that effect is executed by the employer and the employee in writing. I further understand that the at-will nature of my employment may not be changed or modified by any written document, policy manual, statement, or other conduct unless such change or modification is specifically agreed to in writing by an officer of the company.
I understand that this application for employment will be considered active for a period of time not to exceed 45 days.
Signature / Date