ULUKE

Employment Application

*First Name:
*Last Name:
*Street Address:
*City:
*State:
*Zip Code:
*Phone Number:
Email Address:
Have you ever worked for Luke Oil before?:	Yes No
If so, when?:	to
Position?:
Have you ever applied at Luke Oil before?:	Yes No
If so, when?:
Can present employer be contacted?:	Yes No
Were you referred by a Luke Oil Employee?:	Yes No
If so, whom?:
* Desired starting pay($)?:	Per Hour Per Week
* How many hours per week do you want to work?:
* Are you willing to work?: (check all that apply)	Nights Overtime Weekends Holidays
* When could you begin work?:
Are you at least 18 years old?	Yes No

* Did you graduate from high school or earn a GED?:	Yes No
Did you graduate from college, university, business, or trade school?:	Yes No
Name and location of college, university, business or trade school
Major field of study:
Degree earned:
Hours credit

Name of present or last employer
Type of business
Street Address
City
State
Dates of employment	to
Starting salary
Leaving salary
Job title
Straight Truck
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Tractor/Trailer
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Doubles
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Other
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Name of supervisor
List the states operated in for the last five (5) years:
List additional courses, training, experience or awards:
Explain reasons/circumstances for changing or wanting to change jobs
If we contact this employer, would you expect them to say they would rehire you for a position you last held there?	Yes No
If no, please explain.
Employer's phone number

Previous Employer #2
Type of business
Street Address
City
State
Dates of employment	to
Starting salary
Leaving salary
Job title
Straight Truck
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Tractor/Trailer
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Doubles
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Other
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Name of supervisor
List the states operated in for the last five (5) years:
List additional courses, training, experience or awards:
Explain reasons/circumstances for changing or wanting to change jobs
If we contact this employer, would you expect them to say they would rehire you for a position you last held there?	Yes No
If no, please explain.
Employer's phone number

Previous Employer #3
Type of business
Street Address
City
State
Dates of employment	to
Starting salary
Leaving salary
Job title
Straight Truck
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Tractor/Trailer
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Doubles
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Other
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Name of supervisor
List the states operated in for the last five (5) years:
List additional courses, training, experience or awards:
Explain reasons/circumstances for changing or wanting to change jobs
If we contact this employer, would you expect them to say they would rehire you for a position you last held there?	Yes No
If no, please explain.
Employer's phone number

Previous Employer #4
Type of business
Street Address
City
State
Dates of employment	to
Starting salary
Leaving salary
Job title
Straight Truck
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Tractor/Trailer
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Doubles
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Other
Type of equipment (Van, Tank, Flat, etc)
Approximate # of miles
Name of supervisor
List the states operated in for the last five (5) years:
List additional courses, training, experience or awards:
Explain reasons/circumstances for changing or wanting to change jobs
If we contact this employer, would you expect them to say they would rehire you for a position you last held there?	Yes No
If no, please explain.
Employer's phone number

Last Accident
Date
Nature of accident (head-on, rear-end, etc)
Fatalities
Injuries
Next Previous
Date
Nature of accident (head-on, rear-end, etc)
Fatalities
Injuries
Next Previous
Date
Nature of accident (head-on, rear-end, etc)
Fatalities
Injuries

Drivers License#
State
CDL Endorsements
Expiration Date
Drivers License#
State
CDL Endorsements
Expiration Date

Have you ever been denied a license, permit or privilege to operate a motor vehicle? *	Yes No
If yes, please explain:

Has your license, permit or privilege to operate a motor vehicle ever been suspended? *	Yes No
If yes, please explain:

Have you ever been convicted of or pled 'No Contest' to a crime involving theft, dishonesty, violence, drugs, or endangerment of persons or property, whether resulting in incarceration, probation, or a suspended or deferred sentence? *	Yes No
Conviction of a crime will not necessarily disqualify you from consideration for employment.

Attach resume file