Greyco Employment Application 14710 Park Almeda Drive, Houston, Texas 77047 Call Us: 713.728.6264 Email Us: info@greyco.net GREYCO PERSONNEL EMPLOYMENT APPLICATION Today’s Date * First Name * Middle Initial Last Name * Address * Address Address Building/Apartment/Suite # Building/Apartment/Suite # City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Phone Number * Additional Phone Number Date of Birth * Email Address * Enter Email Confirm Email Address * Confirm Email Date Available * Position Applying For: * Desired Pay: * $ How Did You Hear About Position: * Friend Website Social Media OtherOther If you selected friend, please enter their name so we can thank them. Are you Over The Age of 18? * Yes No Are you authorized to work in the U.S.? * Yes No Have you ever applied to this company before? * Yes No If so, when?If so, when? Have you ever worked for this company before? * Yes No If so, when?If so, when? Do you have previous seismic or solar experience? * Yes No If yes, how many years? Are you able to work Sunday through Saturday and holidays, if position requires? * Yes No If no, please explain.If no, please explain. Can you travel, if position requires? * Yes No If no, please explain.If no, please explain. Would you be able to work in all climate outdoor exposures, extreme cold/hot climates and exposure to thick foliage, exposure to moderate winds, light rain, snow and all forms of regional wildlife if the position requires it? * Yes No If no, please explain.If no, please explain. Do you have a valid driver license? * Yes No EXPIRATION DATE * DRIVERS LICENSE NUMBER * STATE * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE New Jersey NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV Drivers License been suspended or revoked in the past 3 years? * Yes No Have you ever been convicted of a felony? * Yes No If yes, please explain.If yes, please explain. We Are An Equal Opportunity Employer. We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, disability, genetic information or any other status protected by law or regulation. It is our intention that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors. REFERENCES List three professional or personal references. FULL NAME Relationship? Phone Number * FULL NAME Relationship? Phone Number * FULL NAME Relationship? Phone Number * Are you currently employed? * Yes No Current/Previous Employment Information Current/Previous Employer * Address * Address Address Building/Suite # Building/Suite # City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Employer Contact Number * Position/Title * Seismic/Solar Experience? * Supervisor * Years With Employer * May we contact this employer? * Yes No Starting Salary * Ending Salary * Employment History Please list employment history for the past 3 years beyond current/previous employer. Employer * Address * Address Address Building/Suite # Building/Suite # City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Postion/Title * Years With Employer * Monthly Income * Add Remove Education High School * Address Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal From * To * Did You Graduate? * Yes No College or Trade School Address Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal From To Did You Graduate? Yes No Degree? Add Remove Special Training or Experience List any special training and all types of seismic or solar equipment you have experience with. Type Equipment Details Dates Type Equipment Details Dates Type Equipment Details Dates DISCLAIMER AND SIGNATURE By my signature below, I certify that my answers are true, accurate and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my file or interview may result in my termination. I agree that this form in original, faxed, photocopied or electronic (including electronically signed) form; will be valid for any background reports that may be requested by or on behalf of the Company and/or its clients. I acknowledge that I received the Consumer Disclosure and Authorization of Background Investigation form. Consent * I agree Authorization of Background Investigation I have carefully read and understand this Disclosure and Authorization form and the attached summary of rights under the Fair Credit Reporting Act. By my signature above, I consent to preparation of background reports by a consumer reporting agency, hired by the Company or its clients (the “Company”),and to the release of such background reports to the Company and any of their designated representatives and agents, for the purpose of assisting the Company in making a determination as to my eligibility for employment (including independent contractor assignments, as applicable), promotion, retention or for other lawful employment purposes. I understand that if the Company hires me or contracts for my services, my consent will apply, and that the Company may obtain background reports, throughout my employment or contract period. I understand that information contained in my employment or contractor application, or otherwise disclosed by me before or during my employment or contract assignment, if any, may be used for the purpose of obtaining and evaluating background reports on me. I also understand that nothing herein shall be construed as an offer of employment or contract for services. I hereby authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal, state and local), motor vehicle records agencies, my past or present employers, the military, and other individuals and sources to furnish any and all information on me that is requested by the consumer reporting agency. I understand that a Company client may conduct background investigations to confirm my eligibility to work on its premises during my employment with the Company. Accordingly, I hereby authorize the Company to provide its clients with information that can be used to conduct a background investigation, such as my birth date, social security number, country of citizenship, and any other information that I have provided to the Company that might be used in conducting a background investigation of me. I hereby release and hold harmless the Company for the disclosure of this information to its clients. By my signature in the application, I also certify the information I provided on and in connection with this form is true, accurate and complete. I agree that this form in original, faxed, photocopied or electronic (including electronically signed) form; will be valid for any background reports that may be requested by or on behalf of the Company and/or its clients. Consent * I agree CONSUMER DISCLOSURE AND AUTHORIZATION FORM The Company and/or its clients (collectively the “Company”) may request, for lawful employment purposes, background information about you from a consumer reporting agency in connection with your employment or application for employment (including independent contractor assignments, as applicable). This background information may be obtained in the form of consumer reports and/or investigative consumer reports (commonly known as “background reports”). These background reports may be obtained at any time after receipt of your authorization and, if you are hired or engaged by the Company, throughout your employment with the Company or your contract period. The types of information that may be obtained include, but are not limited to: social security number verifications; address history; credit reports and history; criminal records and history; public court records; driving records; accident history; worker’s compensation claims; bankruptcy filings; educational history verifications (e.g., dates of attendance, degrees obtained); employment history verifications (e.g., dates of employment, salary information, reasons for termination, etc.); personal and professional references checks; professional licensing and certification checks; drug/alcohol testing results, and drug/alcohol history in violation of law and/or company policy; and other information bearing on your character, general reputation, personal characteristics, mode of living and credit standing. This information may be obtained from private and public record sources, including, as appropriate: government agencies and courthouses; educational institutions; former employers; personal interviews with sources such as neighbors, friends and associates; and other information sources. If the Company should obtain information bearing on your credit worthiness, credit standing or credit capacity for reasons other than as required by law, then the Company will use such credit information to evaluate whether you should be offered a position or be permitted to retain your position. You may request more information about the nature and scope of any investigative consumer reports by contacting the Company. A summary of your rights under the Fair Credit Reporting Act is also being provided to you. Signature * Clear reCAPTCHA If you are human, leave this field blank. SUBMIT Δ