First Name *

Last Name *

Home Address*

City*

State*

Zip Code *

Email Address *

Phone #*

Date Available*

Desired Salary?*

Are you a citizen of the United States?*
Yes
No

If no, are you authorized to work in the U.S.?
Yes
No

Have you ever worked for this company?*
Yes
No

If so, when?

School Name*

Address*

City*

State*

Major*

High School Business or Trade School College Professional School

Did you graduate?*
Yes
No

Year

School Name

Address

City

State

Major

High School Business or Trade School College Professional School

Did you graduate?
Yes
No

Year

School Name

Address

City

State

Major

High School Business or Trade School College Professional School

Did you graduate?
Yes
No

Year

Employer name

Phone #

Address

Supervisor

Job title

Starting salary

Ending salary

Responsibilities

Start date

End date

Reason for leaving

May we contact your previous supervisor for reference?
Yes
No

Employer name

Phone #

Address

Supervisor

Job title

Starting salary

Ending salary

Responsibilities

Start date

End date

Reason for leaving

May we contact your previous supervisor for reference?
Yes
No

Employer name

Phone #

Address

Supervisor

Job title

Starting salary

Ending salary

Responsibilities

Start date

End date

Reason for leaving

May we contact your previous supervisor for reference?
Yes
No

Do you have experience operating heavy equipment? Describe.

Do you have a CDL?*
Yes
No

Would you be interested in acquiring a CDL through Buckeye Pipeline Construction?*
Yes
No

Stay away work is likely at BPC from time to time. Would you *
Prefer
Be Okay With
Not Want

Will working days in excess of 8hrs in all weather conditions be an issue for you if employed for BPC?*
Yes
No

Branch

From

To

Rank at discharge

Type of discharge

If other than honorable, explain

Have you ever been convicted of a felony?*
Yes
No

If yes explain

Have you had any points/suspensions on your license that we should be aware of?*
Yes
No

If yes, explain

Would you be willing to take a pre-employment drug screening?*
Yes
No

If no, explain

Resume Upload:

*I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained in this application and the references listed on my application to give you any and all information concerning my previous employment and any pertinent information they may have, personally or otherwise, and release all parties from all liability for any damage that may result from furnishing the same to you. I agree to not disclose or permit disclosure of any financial or proprietary information or trade secrets of the employer that may be learned during the course of my employment. I understand and agree that, if hired, my employment is at will and for no definite period, and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.