Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

####

Are you over the age of 18? *

Yes

No

Do you have reliable transportation? *

Yes

No

Are you legally allowed to work in Canada? *

Yes

No

Have you previously been employed with Attack Oilfield Services? *

Yes

No

Start Date *

MM

DD

YYYY

End Date

MM

DD

YYYY

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

License *

Class 1

Class 3

Class 5

Tickets *

Select all that apply

Confined Space

CSO

First Aid & CPR Level 1

Ground Disturbance

H2S Alive

WHMIS

Wildfire Orientation

Phone Number *

(###)

###

####

Phone Number *

(###)

###

####

Phone Number

(###)

###

####

Application Acknowledgement *

I WILL PARTICIPATE IN SAFETY COURSES REQUIRED AND OFFERED BY THE COMPANY. I UNDERSTAND THAT I AM SUBJECT TO 'PRE-EMPLOYMENT' AND 'FOR-CAUSE' TESTING FOR SUBSTANCE ABUSE, AND MAY BE REQURED TO UNDERGO AN ALCOHOL/DRUG TEST AT A MEDICAL FACILITY DESIGNATED BY THE COMPANY. I FURTHER UNDERSTAND EMPLOYMENT IS CONDITIONAL UPON A NEGATIVE RESULT.

I CERTIFY THAT THE STATEMENTS MADE IN THIS APPLICATION ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT PROVIDING FALSE INFORMATION IS GROUNDS TO DISQUALIFY MY APPLICATION OR RESULT IN DISMISSAL FOR JUST CAUSE.