Please copy text to Microsoft Word and fill in the information. Then Email a copy to IAR59@aol.com with Application in the subject line.

 

 

INITIAL ATTACK RESOURCES

TRACEY & NANCY LYON

23444 HWY 50

MERRILL, OR 97633

HM-541-798-5959

MOBILE-541-891-9866

FAX-541-798-1080

 

EMPLOYMENT APPLICATION

In compliance with federal and state equal opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion or sex, national origin, age, marital status or non job related disability

 

DATE__________

 

  • POSITION APPLIED FOR______________________
  • RATE OF PAY EXPECTED_____________________
  • NAME FIRST___________MID______________LAST__________________
  • MAILING ADDRESS STREET________________CITY_________________
  • STATE____________ZIP_____________
  • PHONE___________________EMAIL_________________
  • IN CASE OF EMERGENCY NOTIFY _________________PH____________
  • DO YOU HAVE A LEGAL RIGHT TO WORK IN THE U.S. YES/NO
  • ARE YOU A U.S. CITIZEN YES/NO
  • ARE YOU 18 OR OLDER YES/NO
  • PHYSICAL FITNESS TEST HEIGHT ________WEIGHT_______
  • DOB____/_____/______
  • SOCIAL_____-_____-_____ FOR BACKGROUND CHECK
  • DO YOU HAVE A VALID DRIVERS LICENCE YES/NO
  • DRIVERS LICENCE NUMBER_____________STATE______
  • DO YOU HAVE A CURRENT CDL YES/NO
  • DO YOU HAVE ANY OF THE FOLLOWING
  • FIRST AID CARD YES/NO – CPR CARD YES/NO
  • FIRST RESPONDER YES/NO - EMT (B / P) YES/NO
  • HAVE YOU EVER BEEN CONVICTED OF A FELONY YES/NO

 

  • HAVE YOU EVER WORKED FOR THIS COMPANY BEFORE YES/NO
  • IF YES WHERE_______________DATES FM_________TO____________

 

  • EDUCATION

 

  • DO YOU HAVE A HIGH SCHOOL DIPLOMA OR GED YES/NO
  • COLLEGE ATTENDED ____________________DEGREE_______________
  • CREDIT HOURS________________

 

 

 

 

 

  • EXPERIENCE AND QUALIFICATIONS

 

  • ARE YOU CURRENTLY QUALIFIED FOR THE POSITION YOU ARE APPLYING FOR YES/NO
  • DO YOU CURRENTLY HOLD ANY OF THE FOLLOWING

 

  • FFT2 FIREFIGHTER BASIC 40 HOUR COURSE YES/NO IF YES PLEASE LIST WHERE_______________DATES TAKEN_______________

INSTRUCTOR_______________________

 

  • S-216 OR AN ENGINE ACADEMY YES/NO

 

  • FFT1 ADVANCED FIREFIGHTER YES/NO

 

  • SINGLE RESOURCE BOSS (CRWB) (ENGB) YES/NO

 

  • CHAINSAW QUALIFIED SAWYER YES/NO – A/B/C

 

  • ANY ADDITIONAL QUALIFICATIONS _____________________________

 

  • __________________________________________________________________

 

  • __________________________________________________________________

 

 

EMPLOYMENT HISTORY

 

·        LAST EMPLOYER_____________________________________________

·        CONTACT_________________PH_________________________________

·        ADDRESS_____________________________________________________

·        POSITION HELD_______________________________________________

·        REASON FOR LEAVING_____________________________

·        FROM_________________TO___________________

 

·        SECOND EMPLOYER__________________________________________

·        CONTACT_________________PH_________________________________

·        ADDRESS_____________________________________________________

·        POSITION HELD_______________________________________________

·        REASON FOR LEAVING_____________________________

·        FROM_________________TO___________________

 

BY SIGNING THIS I DO HERBY DECLAIR THAT THIS APPLICATION WAS FILLED OUT BY ME AND THAT ALL THE INFORMATION IN IT IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.

·        INITIAL HERE__________

I AUTHORIZE YOU TO MAKE SUCH INVESTIGATIONS AND INQUIRES OF MY PERSONAL, EMPLOYMENT, FINANCIAL OR MEDICAL HISTORY AND OTHER RELATED MATTERS AS MAY BE NECESSARY IN ARRIVING AT AN EMPLOYMENT DECISION. I HERBY RELEASE EMPLOYERS, SCHOOLS, HEALTH CARE PROVIDERS AND OTHER PERSONS FROM ALL LIABILITY IN RESPONDING TO INQUIRIES AND RELEASING INFORMATION IN CONNECTION WITH MY APPLICATION

·        INITIAL HERE__________

IN THE EVENT OF EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN MY APPLICATION OR INTERVIEW(S) WILL RESULT IN IMMEDIATE DISCHARGE. I ALSO UNDERSTAND THAT I AM REQUIRED TO ABIDE BY ALL THE RULES AND REGULATIONS OF THE COMPANY.

·        INITIAL HERE__________

I UNDERSTAND THAT INITIAL ATTACK RESOURCES, INC AND GREY WOLF ENTERPRISES IS AN EMPLOYEE-AT-WILL

 

 

 

TODAYS DATE__________

 

APPLICANTS SIGNATURE_______________________

 

PRINTED NAME_______________________

 

IF SIGNING THIS FROM OUR WEB SITE YOU NEED NOT FILL IN THE INITIAL BOXES OR THE SIGNATURE BOX. IF HIRED YOU WILL DO THIS IN PERSON TO COMPLETE THIS FORM.

 

VERY RESPECTFULLY,

LYON, TRACEY

PRESIDENT INITIAL ATTACK RESOURCES INC