Submit Your Online Application Here

PERSONAL INFORMATION
*First Name:
 *Last Name:
 Middle Name:
*Current Street Address:
*City:
 *State:
*Zip Code:
 *E-mail:
 *Citizenship:
USA Other
Home Telephone:
 *Cell Telephone:
 Work Telephone:

VERIFICATION INFORMATION
NOTE: The information in this section is used for verification purposes only. Because it is not used to make a hiring decision, you may omit some or all of this data if you prefer without effecting your status as a candidate for employment.
*Date of Birth:
 Relationship Status:
Married Single
Widowed Divorced
No. of Dependents:
 If Married, Spouse's Name and Occupation:

EDUCATIONAL INFORMATION
Select highest level of education
you have received:		 High School:
9 10
11 12
College:
1 2
3 4
 Grad:
1 2
Type of School Name and Location
of School		 Graduation Date
(dd/mm/yyyy) 		Degree/Major
High School
College
Grad

MILITARY BACKGROUND
NOTE: A record of a less than honorable discharge will not automatically disqualify you from consideration as a candidate for employment.
Have you ever served in the military?
Yes No		 Country?
USA Other		 Are you in the active reserves?
Yes No
Date entered
Date Discharged/ Retired
Rank at Discharge
Military Branch

MOTOR VEHICLE INFORMATION
NOTE: Lack of driver's license or history of driving violations will not automatically disqualify you from consideration as a candidate for employment.
*State Issuing Driver License Driver License Expiration Date
*Has your driver's license ever been revoked or suspended? Yes No
*Has any company ever cancelled your motor vehicle insurance? Yes No
*Have you been convicted of driving under the influence of alcohol or drugs? Yes No
*Have you ever been convicted of a moving violation within the past 3 years? Yes No
*Have you ever caused a motor vehicle accident? Yes No
*Have your been involved in any way in a motor vehicle accident within the past 3 years? Yes No
*Have you been convicted of reckless driving? Yes No

CRIMINAL HISTORY
NOTE: A conviction will not automatically disqualify you from consideration as a candidate for employment.
*Have you been convicted of any offense during the past ten years? Yes No
If yes, please explain below:

WORKER'S COMPENSATION INFORMATION
NOTE: Knowledge of pre-existing injuries allows us to match applicants with jobs which do not exceed their physical limitations, minimize the risk of further injury, and take advantage od second injury funds in certain states. Worker's compensation claims will not automatically disqualify you from consideration as a candidate for employment
*Have you ever filed a worker's compensation claim? Yes No
If yes, please explain below (Date, Type):

EMPLOYMENT INFORMATION
*Position applying for: Date available:
Rate of pay expected: Are you available to work:
Full-time Part-time Overtime Night Shift
Referred by:

ADDITIONAL EMPLOYMENT INFORMATION
Were you previouly employed by us? Yes No Are you at least of the age of 18 years? Yes No
Have you ever applied with us before? Yes No Mechanical Experience? Yes No
Do you have any friends or relatives working for us? Yes No Have you served an apprenticeship? Yes No
If yes, please list them:
 How long?

Trade?
Except for vacations and holidays, how many days were you absent from work during the past year? Please state reasons for absences:
Have you ever been involuntarily discharged by an employer? Yes No If yes, explain:
Are there any experiences, skills, or qualifications which you feel would especially fit you for work with the Company?

WELDING POSITION
If applying for a welding position please select the welding processes and positions and material you are certified for.
Note:Please make sure you select if you are certified for CS-Carbon Steel, SS-Stainless Steel or both.
VESSEL - PIPE WELDERS
PROCESS CS SS 1G 2G 5G 6G
SMAW (1,4) 6"XXH
SMAW (2) 2"XXH
FCAW (3) 6"XXH
GMAW (5,6) ROOT 6"XXH
FCAW (5) ROOT 6"XXH
SAW (7) 1 1/2" PLATE
GTAW (TIG) (8) 2"XXH
FCAW (9) STRUCTURAL
SMAW (10) STRUCTURAL
VISUAL (11)
SKID - STRUCTURAL WELDERS
PROCESS CS SS 1G 2G 3G 4G 1F 2F 3F 4F
SMAW (1,4) 6"XXH
SMAW (2) 2"XXH
FCAW (3) 6"XXH
GMAW (5,6) ROOT 6"XXH
FCAW (5) ROOT 6"XXH
SAW (7) 1 1/2" PLATE
GTAW (TIG) (8) 2"XXH
FCAW (9) STRUCTURAL
SMAW (10) STRUCTURAL
VISUAL (11)

EMPLOYMENT HISTORY
Give complete name and addresses' of all employers for the last seven years or since high school, whichever is less. Explain unemployment periods between jobs.
EMPLOYER 1
*Employer Name:
 *Supervisor Name:
 *Telephone No.:
*Address:
 *City, State:
 *Zip Code:
*Salary:
 *Date From:
 *Date To:
*Reason for Leaving:
 *Describe Job Duties:
EMPLOYER 2
Employer Name:
 Supervisor Name:
 Telephone No.:
Address:
 City, State:
 Zip Code:
Salary:
 Date From:
 Date To:
Reason for Leaving:
 Describe Job Duties:
EMPLOYER 3
Employer Name:
 Supervisor Name:
 Telephone No.:
Address:
 City, State:
 Zip Code:
Salary:
 Date From:
 Date To:
Reason for Leaving:
 Describe Job Duties:
EMPLOYER 4
Employer Name:
 Supervisor Name:
 Telephone No.:
Address:
 City, State:
 Zip Code:
Salary:
 Date From:
 Date To:
Reason for Leaving:
 Describe Job Duties:
*May we contact the employers listed above? Yes No
If not, indicate which one(s) you do not wish us to contact
PERSONAL/PROFESSIONAL REFERENCES 1
Name:
 Company:
 Title:
Years Known:
 Provide information about how to contact them
(Email ID or Phone number)
PERSONAL/PROFESSIONAL REFERENCES 2
Name:
 Company:
 Title:
Years Known:
 Provide information aboout how to contact them
(Email ID or Phone number)
INFORMATION FOR APPLICANT

TO APPLICANT: We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will aid us in considering you for a position that best meets your qualifications and may assist us in the future if employed.

PLEASE READ THE FOLLOWING STATEMENTS AND MAKE SURE THAT YOU FULLY UNDERSTAND AND AGREE TO THEIR SIGNIFICANCE BEFORE SUBMITTING THIS APPLICATION:

I, hereby apply for employment with Dickson Process Systems, LLC. The facts set forth in my application for employment are true and complete. I understand that if employed, any exclusions or evasive statements on this application or on other company records shall be considered sufficient cause for dismissal.

I understand that Dickson Process Systems, LLC is hereby authorized to make any verification of my personal history, driving record and financial and credit record through any investigative or credit agencies or bureaus of its choice. I understand that such information is kept confidential and is available to me upon written request, and I agree to release all persons and companies requesting or supplying information in regard to this inquiry from all liabilities.

By accepting a job offer from Dickson Process Systems, LLC, I agree and give consent to take a physical examination and a drug screen test before beginning work and also be subject to random drug screening during my employment. I understand and agree that refusal to submit to such testing during the period of my employment may result in disciplinary action, including termination.

By accepting a job offer from Dickson Process Systems, LLC, I agree to abide by the employee and safety rules and policies of Dickson Process Systems, LLC put forward by its management. I understand and agree that if company property and/or equipment is issued to me by Dickson Process Systems, LLC, I will be responsible for the same until it is returned to Dickson Process Systems, LLC.

I understand and agree that if I am employed with Dickson Process Systems, LLC, it will be of an " at will " basis. I also understand that " at will " means that I may resign at any time and Dickson Process Systems may discharge me at any time, with or without reason. I also understand and agree that this " at will " employment relationship cannot be altered by any written document or verbal statement unless this alteration is specifically acknowledged in writing by a Vice President or higher authority of Dickson Process Systems, LLC.

I understand that according to federal law all individuals must provide documents which either confirm their identity as a U.S. citizen or confirm their legal authorization to work in the United States. I understand that any offer of employment is contingent on my ability to produce this documentation within the time required by law.

I have read this Information for Applicant, and I fully understand it's contents.