Altogas General Application Form

Equal access to programs, services and employment is available to all persons without regard to race, religion, sex, age, national origin, color, disability, genetic Information, veteran status, marital status, height, weight, or any other status or classification protected by applicable state or federal law. Those applicants requiring reasonable accommodation to the application and/or interview process please call (800) 998 - 6242 and ask for the Human Resources Department.

Referral Source

Full Name*

First NameMiddle NameLast Name

Email Address*

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Have You Applied for a position with Altogas Before?*

YesNo

If Yes, What Position

Why do you want to work for Altogas?*

Do you have any relatives, family members, or friends employed with Altogas?*

YesNo

If yes, please list name and relationship:

Are you currently employed?*

YesNo

May we contact current employer?*

YesNo

Do you have the legal right to work in the United States? (Proof of eligibility will be required)*

YesNo

If you are under 18 and it is required, can you furnish a work permit?*

YesNo

What are your salary requirements?*

HourlyAnnually

Available Start date*

MonthDayYear

Type of employment desired?*

Full TimePart TimeTemporary

Days and Hours Available to Work?

Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant from employment)*

YesNo

If yes, Please provide dates and details:

Upload Resume

Upload a File

Employer One

Employer*

Phone Number*

Area CodePhone Number

Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Job Title*

Immediate Supervisor*

First NameLast Name

Title*

May we contact for reference?*

YesNo

Salary/Wage (starting)*

Salary/Wage (final)*

Start Date*

Date

End Date*

Date

Reason for Leaving*

Summary of work performed and job responsibilities*

Employer Two

Employer

Phone Number

Area CodePhone Number

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Job Title

Immediate Supervisor

First NameLast Name

Title

May we contact for reference?

YesNo

Salary/Wage (starting)

Salary/Wage (final)

Start Date

Date

End Date

Date

Reason for Leaving

Summary of work performed and job responsibilities

Employer Three

Employer

Phone Number

Area CodePhone Number

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Job Title

Immediate Supervisor

First NameLast Name

Title

May we contact for reference?

YesNo

Salary/Wage (starting)

Salary/Wage (final)

Start Date

Date

End Date

Date

Reason for Leaving

Summary of work performed and job responsibilities

Employer Four

Employer

Phone Number

Area CodePhone Number

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Job Title

Immediate Supervisor

First NameLast Name

Title

May we contact for reference?

YesNo

Salary/Wage (starting)

Salary/Wage (final)

Start Date

Date

End Date

Date

Reason for Leaving

Summary of work performed and job responsibilities

Summarize any special training, skills, licenses and/or certificates you have:*

Select Education Completed*

High school

School

Location

Did you Graduate?

Degree

Major Studied

Average Grade

College

School

Location

Did you Graduate?

Degree

Major Studied

Average Grade

Other

School

Location

Did you Graduate?

Degree

Major Studied

Average Grade

List other courses, seminars, etc.

Reference One

Name*

First NameLast Name

Title*

Phone Number*

Area CodePhone Number

Years Known*

Reference Two

Name

First NameLast Name

Title

Phone Number

Area CodePhone Number

Years Known

Reference Three

Name

First NameLast Name

Title

Phone Number

Area CodePhone Number

Years Known

Organization

Offices Held

Organization

Offices Held

Organization

Offices Held

I certify that all information I have provided is true, complete and accurate.

I expressly authorize the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and nondefamatory information, in a lawful manner, in the employment process.

I understand that this application remains current for only 60 days. At the conclusion of that time, if l have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and complete a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration.

I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if l am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that Federal immigration laws require me to complete an 1-9 Form in this regard.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from employment, whenever it is discovered.

PLEASE DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT CAREFULLY.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Applicant's Signature

Date*

Date

Applicant's Name

First NameLast Name

Please verify that you are human*

Office/General Labor Application for Employment:

AN INCOMPLETE OR ILLEGIBLE APPLICATION FORM MAY RESULT IN DISQUALIFICATION

EMPLOYMENT HISTORY

SKILLS AND QUALIFICATIONS

Education

References

Related Information

Applicant Statement