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1901 Shiloh, Hawaii 81063

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WELCOME TO OUR SAFETY PLUS-U.S.A, LLC

580-622-4469
AllenJ@safetyplus-usa.com

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Want To Work With Safety Plus?

Please apply by filling the form below.

Personal Details

Select which apply for you. *CDLDRIVERNON-DRIVER

Type of CDL *ABC

Commercial Driving License (Optional)

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(Jpeg, Jpg, Jpe, png, PDF, DOC, PPTX) Less than 8mb

Driving License (Optional)

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Prefix

First Name *

Middle Name

Last Name *

Social Security Number *0 / 11

Social Security Card (Optional)

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Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Your Email Address? *Don't enter your employee email id. Add a personal email ID.

Cell Phone *

Home Phone

Desired Position *0 / 20

Please Fill All Areas

Industry References

Name *

Title or Position *

Phone Number *

Name

Title or Position

Phone Number

Name

Title or Position

Phone Number

EMPLOYMENT HISTORY

Please include last two work experience. Please include any dates of unemployment

Please upload an update Resume/CV (Optional)

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Currently Employed? *YesNo

Current Company Name

Employment 1

Employer

Currently Working hereYesNo

From *

To *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Country

Position Title *

Base Pay Per Hour *

# of Hours Worked per Week *

Reason for Leaving

Supervisor First Name

Supervisor Last Name

Telephone Number

May we Contact this Employer?YesNo

Employment 2

Employer

Currently Working hereYesNo

From

Street Address

City

State/Province

ZIP / Postal Code

Country

Position Title

Base Pay Per Hour

# of Hours Worked per Week

Reason for Leaving

Supervisor First Name

Supervisor Last Name

Telephone Number

May we Contact this Employer?YesNo

Where You Unemployed for any Time duration?YesNo

Unemployed From

Unemployed Till

Please Specify If the time duration is more than one.

1. Do you have any physical limitations or previous injuries that will prevent you from performing any work for which you are being considered?YesNo

If yes, please explain:

2. Do you have a clean driving History?YesNo

If No, please completely and fully explain:

3. Are you currently taking doctor prescribed narcotics?YesNo

If Yes, please list:

4. Do you have any mechanical skills?YesNo

If Yes, please list:

5. Have you ever filed a claim against a previous employer?YesNo

If Yes, please explain:

6. Do you have any PEC Training?YesNo

If so please provide documentation

No file chosen

7. Have you ever worked for Safety Plus USA LLC?YesNo

From *

Till *

8. How did you hear about position you’re applying for? If newspaper, which paper?

9. Do you have reliable transportation to get to the yard for a job?YesNo

10. I understand I will be required to pass an observed pre-employment drug screen & physicalYesNo

11. This company conducts criminal background investigations on ALL potential candidates. Have you ever plead guilty to or been convicted of a felony(s) or misdemeanour(s), which has not been expunged (removed) or sealed by a court?YesNo

If yes, please completely and fully explain:

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Address

Safety Plus is a family-owned company that started in 2009.

580-622-4469

info@safetyplus-usa.com

SAFETY PLUS USA, 1091 Fletcher Rd, Sulphur, OK 73086, United States

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