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Position applying for:*

1289 - Class B Mechanic

1288 - Class A Electrician

1287 - Heavy Equipment/Rolling Stock Mechanic

1281 - Class B Machinist

1277 - Inside Sales Representative

6662 - Cost Accountant

Please check all positions you feel you are qualified to apply for.

Name:*

First Last

Please provide your first and last name.

Address:*

Street Address Address Line 2 City State ZIP Code

Please provide your current address.

Telephone number:*

Please provide your current telephone number.

Work History - Please list your last three employers, below.

Employer #1 (Name):*

Please provide the name of your most recent (current) employer.

Employer #1 (Position):*

Please provide the position you held with your most recent (current) employer.

From this Date:*

Please provide the date you started working for your most recent employer. Please estimate if you do not remember the exact day.

To this Date:*

Please provide the last day you worked for your most recent employer. Please estimate if you do not remember the exact day.

Employer #2 (Name):

Please provide the name of your second most recent employer.

Employer #2 (Position):

Please provide the position you held with your second most recent employer. If you have not had more than one employer, leave this section blank.

From this Date:

Please provide the date you started working for your second most recent employer. Please estimate if you do not remember the exact day.

To this Date:

Please provide the last day you worked for your second most recent employer. Please estimate if you do not remember the exact day.

Employer #3 (Name):

Please provide the name of your third most recent employer.

Employer #3 (Position):

Please provide the position you held with your third most recent employer. If you have not had more than two employers, leave this section blank.

From this Date:

Please provide the date you started working for your third most recent employer. Please estimate if you do not remember the exact day.

To this Date:

Please provide the last day you worked for your third most recent employer. Please estimate if you do not remember the exact day.

Skill set:*

Please provide the top 5 skills you believe you possess.

References - Please list three references, below.

Reference #1 (Name):*

First Last

Please provide the first and last name of this first reference.

Reference #1 (Phone):*

Please provide the telephone number of this first reference.

Reference #1 (Relationship):*

Please tell us how you know this first reference.

Reference #2 (Name):

First Last

Please provide the first and last name of this second reference.

Reference #2 (Phone)

Please provide the telephone number of this second reference.

Reference #2 (Relationship):

Please tell us how you know this second reference.

Name

First Last

Please provide the first and last name of this third reference.

Reference 3 (Phone)

Please provide the telephone number of this third reference.

Reference #3 (Relationship)

Please tell us how you know this third reference.

Phone

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<em>Oil City Iron Works, Inc. is an Equal Opportunity Employer.</em>