Employment Application
                                               We are an equal opportunity Employer
Position Applied For:     Date of Application:      
Name:                  
Last First Middle
Address:                  
Street City State Zip
Phone:     Cell:   Fax:      
Date Available to Start:     Social Security Number:      
 
Type of Employment Desired:   Full-Time          Part-Time   Temporary
Have You Ever Been Convicted of a Felony?   YES   NO
If Yes, Please Explain:              
Outstanding Warrants?    If Yes, Explain:            
Any Reason Why You Wouldn't Be Eligible To Get A CDL License? If Yes, Explain:
                 
   
Education? High School Diploma or GED        College?         Years?  
Have You Ever Been Employed Here Before?   YES   NO
 
Are You Legally Eligible for Employment in This Country?   YES   NO
 
Personal References:                
   
                   
  Name Address City State
   
                   
  Phone     How Long Have They Known You?    
   
                   
  Name Address City State
   
                   
  Phone     How Long Have They Known You?    
                        Elite Wireline, Inc.
Page 2         Employment Application
                                               We are an equal opportunity Employer
Work Experience              
From To Employer   Phone  
       
                   
Job Title   Address  
     
                   
Immediate Supervisor   Nature of Work and Responsibilities  
     
                   
Nature of Work (Continued)  
   
                   
Hourly Rate When You Left   Reason for Leaving  
     
                   
From To Employer   Phone  
       
                   
Job Title   Address  
     
                   
Immediate Supervisor   Nature of Work and Responsibilities  
     
                   
Nature of Work (Continued)  
   
                   
Hourly Rate When You Left Reason for Leaving  
     
                   
From To Employer   Phone  
       
                   
Job Title   Address  
     
                   
Immediate Supervisor   Nature of Work and Responsibilities  
     
                   
   
   
                   
Hourly Rate When You Left   Reason for Leaving  
     
                   
I certify That All Information Provided Above is Correct
 Signature:                       Date: