Employment Application | Rolling Plains Management

Rolling Plains Management Corporation is an equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of disability, or any other legally protected status.

Position

Position Title: *

Job ID:

Personal Info

First Name: *

Middle:

Last Name: *

Email Address *

Address: *

State: *

City: *

Zip: *

Cell Phone:

Cell Phone:, part 1

Cell Phone:, part 2

Cell Phone:, part 3

Telephone:

Telephone:, part 1

Telephone:, part 2

Telephone:, part 3

Questionnaire

What is the best time to contact you:

Are you 18 years of age or older? *

Yes

Are you legally eligible to work in the United States? *

Yes

Do you have a valid driver’s license? *

Yes

If yes, give type and license #. (Class C, CDL):

Have you been employed with RPMC before? *

Yes

If yes, give dates:

If yes, give name and relationship:

Are you employed now? *

Yes

If yes, may we contact your present employer for references?

Yes

Date available for work?

Desired Salary Range?

Availability for work:

Full Time

Part Time

Temporary

Can you travel if a job requires it?

Yes

Are you a parent/guardian of a child either currently or formerly enrolled in the RPMC Head Start Program or have you ever volunteered with any program of RPMC? *

Yes

If yes, give details:

Have you been convicted of a felony within the last 7 years? *

Yes

If yes, please explain:

Do you have any current obligation as a result of conditions of probation or parole?

Yes

If yes, please explain:

Veteran of the U.S. Military? *

Yes

If yes, Branch:

Active Duty Discharge Date:

Check any that apply:

Vietnam Veteran

Disabled Veteran

Other

If Other (specify):

Indicate languages, other than English, you speak, read, and/or write:

If the position for which you are applying requires proficiency testing, are you willing to the test? *

Yes

RPMC has a Drug-Free work place policy. If you are employed, you may be required to submit to a drug/alcohol test. Would you be willing to submit to drug/alcohol testing? *

Yes

In the last two (2) years, have you tested positive or refused to test on any pre-employment drug/alcohol test? *

Yes

If offered employment, are you willing to allow a Criminal History Check, Fingerprint Check, Driver's License Check or other relevant background checks to be conducted? *

Yes

Education

Colleges, Universities, or Trade Schools attended

High School or GED completed:

Yes

If no, give highest grade completed:

Name of School:	City / State:	Did you graduate?	Degree / Field of study:
Name of School:	City / State:	Did you graduate?	Degree / Field of study:
Name of School:	City / State:	Did you graduate?	Degree / Field of study:
Name of School:	City / State:	Did you graduate?	Degree / Field of study:
Name of School:	City / State:	Did you graduate?	Degree / Field of study:

List any professional licenses or certifications, special certificates, skills, and/or qualifications (CPR, first aid, computer skills, accounting, bookkeeping, etc.) that apply:

Documentation

Please upload any pertinent documentation (resume, cover letter, etc):

Add a new file

More information

Files must be less than 2 MB.
Allowed file types: txt pdf doc docx ppt pptx xls xlsx.

References

Name: *	Years known: *	Relationship: *	Daytime telephone(s): *
Name: *	Years known: *	Relationship: *	Daytime telephone(s): *
Name:	Years known:	Relationship:	Daytime telephone(s):
Name:	Years known:	Relationship:	Daytime telephone(s):

Employment History

Start with your present or most recent employment. RPMC will assume we may contact these employers for job related references unless you indicate otherwise. Please complete as applicable and do not state to "refer to resume".

Company:

Telephone Number:

Telephone Number: , part 1

Telephone Number: , part 2

Telephone Number: , part 3

Address (include city and state):

Dates of employment:(month and year):

Name and title of supervisor:

Hourly pay:

Job title and describe work performed:

Reason for leaving:

Company:

Telephone Number:

Telephone Number:, part 1

Telephone Number:, part 2

Telephone Number:, part 3

Address (include city and state):

Dates of employment:(month and year):

Name and title of supervisor:

Hourly pay:

Job title and describe work performed:

Reason for leaving:

Company:

Telephone Number:

Telephone Number:, part 1

Telephone Number:, part 2

Telephone Number:, part 3

Address (include city and state):

Dates of employment:(month and year):

Name and title of supervisor:

Hourly pay:

Job title and describe work performed:

Reason for leaving:

Company:

Telephone Number:

Telephone Number:, part 1

Telephone Number:, part 2

Telephone Number:, part 3

Address (include city and state):

Dates of employment:(month and year):

Name and title of supervisor:

Hourly pay:

Job title and describe work performed:

Reason for leaving:

Applicant Statement

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at a decision and I agree to release all parties providing pertinent information from any and all liability from any damages which may result from the furnishings of such information. I understand that all job offers are contingent upon receipt of appropriate of background checks.

RPMC only accepts applications for open positions. I understand that this application may be considered active for a period of up to 60 days.

I understand that neither this document nor any offer of employment from the employer constitutes an employment contract. I also understand that RPMC is an "at-will" employer and employees can be terminated at any time, with or without cause, and with or without notice. I also understand that no employment with RPMC is for a fixed or definite term.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand that all RPMC employees are required to abide by all rules and regulations of RPMC.

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Applicant Statement.

I Accept *