3105 E Skelly Drive, Suite 100

Tulsa, OK 74105-6347

Phone: 918-828-9961
Fax: 918-828-9983

 

  

 

Job Application

Last Name:
First Name:
Middle Initial:
Address:
Apt:
City:
Zip:
Home Phone:
Message Phone / Pager:
Social Security No:
Min. Hourly Salary:
Method of Transportation: Own Car
Bus
Other
Do you have: Steel Toe Boots
Hard Hat
Safety Glasses

Which days can you work?
Shifts: 1st  2nd  3rd
Have you ever been convicted of a felony in the last 5 years? Yes No
Explain:
Please describe any physical, mental, or sensory limitations that should be considered in job placement:

 
© Copyright 2005 Prorenata, LLC All Rights Reserved
(Pro-re-nata)  n  : to take "as needed"