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POWERS OIL COMPANY LTD. Dba Powers Oil & Propane NON-DRIVER EMPLOYMENT APPLICATION

1. Employer Information

Employer: Powers Oil Ltd. Address: 1681 West Main St. Telephone: 330-821-8387 City/State/ZIP: Alliance, Ohio 44601

2. Applicant Information

Applicant Name(Required)
Applicant Address(Required)
(If less than 3 years provide additional addresses)
Additional Address
(State, Number, Expiration)

3. Emergency Contact

Emergency Contact Name(Required)
Address(Required)

4. Job Position Applied For

Have you been a licensed driver for at least 5 years?(Required)
If applicable, are you able to work overtime?(Required)
MM slash DD slash YYYY
Are you legally eligible for employment in the United States?(Required)
Are you able to perform the essential functions of the job for which you are applying with reasonable accommodations, including those that require moderate to heavy lifting?(Required)
Have you ever been convicted of any crime, including traffic violations?(Required)
Have you ever been involved in any traffic accidents/crashes?(Required)
Have you ever had a denial, revocation, or suspension of any license, permit, or privilege to operate a motor vehicle?(Required)

5. Applicant's Skills and Qualifications

Check those skills that you have. List any other skills that may be useful for the job you are seeking. Enter the number of years of experience, and circle the number which corresponds to your ability for each particular skill. (One represents poor ability, while five represents exceptional ability.)
Please select from the following abilities or skills that apply:
(Please select all that apply.)

6. Applicant's Employment History

List jobs for past 3 years and if applying for a Commercial Driving position include the past 10 years for commercial driving experience: *Note: FMCSRs stands for Federal Motor Carrier Safety Regulations

First Employer

Address
MM slash DD slash YYYY
Are you still working at this company?
MM slash DD slash YYYY
Were you subject to the FMCSRs while employed by that employer?

Second Employer

Address
MM slash DD slash YYYY
Are you still working at this company?
MM slash DD slash YYYY
Were you subject to the FMCSRs while employed by that employer?

Third Employer

Address
MM slash DD slash YYYY
Are you still working at this company?
MM slash DD slash YYYY
Were you subject to FMCSRs while employed by that employer?

Fourth Employer

Address
MM slash DD slash YYYY
Are you still working for this company?
MM slash DD slash YYYY
Were you subject to FMCSRs while employed by this employer?

7. Applicant's Education and Training

Did you graduate from High School?(Required)
Did you receive your GED?(Required)
Did you attend College/University?(Required)
Did you receive a degree?(Required)
Military Service
Name(Required)
Address(Required)
Name(Required)
Address(Required)
Name(Required)
Address(Required)
I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.   I understand that the information submitted on this application will be used for the purpose of investigating the applicant’s background, including contacting the applicant’s prior employers and obtaining the applicant’s driving record as well as driving performance history for the preceding three years for each DOT regulated employer as well as the state or appropriate agency for which a motor vehicle operator’s license is held. I authorize Powers Oil Ltd to contact former employers, the State and/or appropriate agency, as well as educational organizations regarding my employment, driving record, driving safety performance history and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education. I understand that as a part of the Hazardous Materials Endorsement Threat Assessment Program, the TSA implemented on January 31, 2005 and Powers Oil Ltd. dba Powers Oil and Propane’s driver qualification policy a criminal background check will be conducted at the time of hire and as needed in the future to meet the company’s security plan and Hazardous Materials Endorsement compliance. I authorize Powers Oil Ltd. to conduct a criminal background check both now and in the future.   If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Owner, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Powers Oil Ltd, except in a specific written contract of employment signed on behalf of the organization by its Owner, has the power to alter or vary the voluntary nature of the employment relationship.   I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS. THIS CERTIFIES THAT THIS APPLICATION WAS COMPLETED BY ME, AND THAT ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
Name(Required)
Reset signature Signature locked. Reset to sign again
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.

1681 W. Main St.
Alliance, OH 44601

Contact Us

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330.821.8387



330.823.3130



customercare@powersoilandpropane.com

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