Application – Westpac Pipeline

PERSONAL INFORMATION

Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Email *

Phone *

Are you 18 years or older? *

EMPLOYMENT DESIRED

Position

Date you can start *

Salary desired *

Are you employed now? *

May we inquire of your present employer? *

Ever applied to Westpac before? *

If yes, what position?

When?

Referred by

EDUCATION

High School *

No. Years Attended *

Graduate? *

College

No. Years Attended

Graduate?

Trade School or Other

No. Years Attended

Graduate?

If Trade School, what did you study?

SPECIAL SKILLS

Please list any additional, relevant skills for this position.

Military Service

None
Army
Navy
Air Force
Marines
Coast Guard

Military Rank

Currently National Guard or Reserves?

FORMER EMPLOYERS

List your last three employers below, starting with the most recent one first.

Name and Address of Employer (Most Recent or Current)

From

Salary

Position

Reason for Leaving

Name and Address of Employer #2

From

Salary

Position

Reason for Leaving

Name and Address of Employer #3

From

Salary

Position

Reason for Leaving

If you would also like to upload a resume in PDF or DOC format only, you may do that here before finishing the last step in the process on the next page.

File Upload

REFERENCES

List the names of three persons not related to you, whom you have known at least one year.

Reference #1 *

Role & Company

Phone *

Years Acquainted

Reference #2 (with Phone Number) *

Role & Company

Phone *

Years Acquainted

Reference #3 (with Phone Number) *

Role & Company

Phone *

Years Acquainted

I certify that all the information submitted by me on this application is true and cmplete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed my employment may be terminated at any time.

In consideration of my employment, I agree to conform to to Westpac Pipeline's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its President and/or CEO, and then only when in wrong and signed by the President and/or CEO, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement to the contrary.

I acknowledge the paragraph above.

Date / Time *

Full Name *

Spam Protection Question *