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Do you have previous on the job pipeline experience?

What were your duties?

Are you willing to work out of town?

Are You 18 Years or Older?

Are you subject to an employment agreement that restricts your activities in any way? 

Are you a US Citizen or do you have a valid US work Permit or Visa? 

Have you ever been convicted of a crime?

Education/Training History

Graduated

Work References: (ie Foreman, Boss, Supervisor. Do not use family members.)

License/Registration/Certificate

Complete the following for jobs requiring a professional license, registration, certificate, AR/OK CDL, Welder Certification, OSHA cards, Safety cards, First Aid Cards, etc.  NOTE:  Your driving records will be checked if the position requires CDL or Medical Card.

Specialized Skills & Knowledge

List any skills or knowledge that show your ability to perform the job for which you are applying (ie equipment you have the specialized knowledge to effectively run.)

List your last three employers for employer verification purposes.

Current or Last Employer:

Employer 2

From Month/Year

To Month/Year

Employer 3

From Month/Year

To Month/Year

Employer 4

To Month/Year

From Month/Year

“I certify that all the information submitted by me on this application is true and complete, and understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.  In consideration of my employment, I agree to conform to the company’s rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without notice, at any time by the company.  I understand that no company representative, other than its president, in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.”

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Office: 479-474-0656 

Physical: 4332 Dora Road Van Buren, AR 72956
Mailing Address: 4332 Dora Road Van Buren, AR  72956
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Affliations:

National Compliance Management Service, Inc.

TPS Alert

NCMS 

Pipeline Testing Consortium, Inc.

Gold Shovel Standard

ISNetworld RAVS Plus Participant

DIRT

America Health Care Academy

Axiom Medical

BROWZ

Energy World Net

Veriforce

NUCA

ETrainToday

360 Training

© 2017 Fowlkes Pipeline, Inc. 

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