Spartan Resources Employment Application
This application must be completed in its entirety.

PERSONAL INFORMATION

Name: First:    Last:
  By Checking this box I certify that I am at least 18 years old.
Telephone: Home:    Work/Cell:
Email Addresses: Main:    2nd:
Current Address: Street:    City:
  State:   Zip Code:

If you have been at your current address for less than 24 months, please list your previous address:
Previous Address: Street:    City:
  State:    Zip Code:


Have you ever used any other name(s) which is (are) necessary for us to know to enable us to verify your employment or educational record? Yes No

   If yes, please specify:

EMPLOYMENT

Type of Position Desired
If offered a position, when would you be available to start work? 
   If other, please explain:

Have you ever applied at Spartan Resources, LLC before? Yes No
   If yes, when ?
   For what position ? 
 
How did you hear about our job opening/organization?
Were you referred by an employee of Spartan Resources, LLC or affiliate company? Yes No
   If yes, name of employee?
List any relatives currently employed by this organization:
Please enter your birthdate:
Do you have unrestricted right to accept employment in the United States ? Yes No
Will you need Spartan Resources, LLC to petition for continued work authorization in the future? Yes No
 
Have you ever been convicted of a misdemeanor or felony ? Yes No
   If yes, please explain offense and dates:
   
 
Are you currently awaiting trial for any criminal offense? Yes No
   A "yes" answer will not necessarily disqualify you. Please explain any "yes" answer
   so the individual circumstances can be considered:
    

EDUCATION ( high school and above, including technical schools )

Name and Location of School Diploma / Degree Received Year Earned

SPECIAL SKILLS/ADDITIONAL INFORMATION

Please list any special skills or additional information that relate to your ability to perform the job for which you have applied such as licenses, professional memberships, military service, hobbies, etc. (Omit those that indicate your race, religion, color, national origin, ancestry, gender or age.)
  

EMPLOYMENT HISTORY

( Starting with most recent, please provide details of your last two employers, even if listed on your resume.)
Current Employer:
  Employment Dates:
from    to  
  Address:
  Supervisor Name & Title: Phone:
  Reason for leaving:
  Job Title: Pay:
  Your Duties:
 
Previous Employer:
  Employment Dates:
from    to  
  Address:
  Supervisor Name & Title Phone:
  Reason for leaving:
  Job Title: Pay:
  Your Duties:
  WE WILL NOT CONTACT CURRENT OR PAST EMPLOYERS WITHOUT VERBAL CONSENT FROM APPLICANT

REFERENCES (Do not Include Relatives or Family Members.)

Please list at least three technical or business references from individuals familiar with your work ability.
 Name  Telephone / Email  Professional Relationship  Years Known
       
       
       
       

CONSUMER REPORT DISCLOSURE AND AUTHORIZATION

  By checking this box you indicate that you have read and agree with the above Consumer Report Disclosure & Authorization Agreement:

APPLICANT'S STATEMENT

I understand that nothing contained in the application or conveyed during any interview which may be granted, is intended to create an employment contract between myself and the Company.  In addition, I acknowledge that in the event that I am employed by Spartan Resources, LLC Incorporated, my employment is at-will and for no definite or determinable period and may be terminated at any time, with or without prior notice or cause, at the option of either myself or the Company.  I agree to submit to all employment-related disputes with my employer to arbitration.

I understand that the employer will thoroughly investigate my work and personal history and verify all data given on this application, on related papers, and in interviews. I authorize all individuals, schools, and firms named therein, except my current employer if so noted, to provide any information requested about me, and I release them from all liability for damage in providing this information.

I understand that federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity. Failure to submit such proof will result in denial of employment.

I understand this application will be active for a period of sixty days. After that time, if I wish to be considered for employment, I must submit a new application.

I certify that all the statements herein are true and understand that any falsification, misrepresentation, or willful omission shall be sufficient cause to refuse offer of employment or constitute grounds for dismissal at any time during my employment.  I voluntarily and knowingly authorize investigation of any information presented.

My signature below certifies that I agree to the employment at will relationship and agree to be bound by the terms and conditions of employment, including arbitration of disputes as set forth in the Arbitration Agreement, if employed by Spartan Resources, LLC.

By entering your name below in lieu of an actual signature, and clicking the Submit Application button, you agree to abide by the terms of the APPLICANT's STATEMENT above.
 Signature:  Today's date: 05/21/2013