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Company that you are applying to:
Spearfish Oilfield Supply
Basin Service Company, Inc.
Basin Well Service, Inc.
Position You're Applying For
(Required)
Diesel Mechanic, Minot, ND
Heavy Duty Shop Service Tech, Minot, ND
Hot Oil Truck Driver/Operator, Westhope, ND
Other
Position You're Applying For
(Required)
Derrickhand
Floorhand
Other
Spearfish Oilfield Supply, Inc. is not currently hiring.
There are no openings for the company you have selected. Please check back later!
Consent
(Required)
I authorize you to make sure investigations and inquiries to my personal, employment, financial, or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only of and after a conditional offer of employment has been extended.)
I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, also, that I am required to abide by all rules and regulations of the Company.
I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance as required by 49CFR 391.23(d) and (e).
I understand that I have the right to:
– Review information provided by current/previous employers;
– Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
– Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
Applicant agrees to the above statement
Your Personal Information
Your Name
(Required)
First
Middle
Last
Your Email Address
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
List any other additional addresses (include last 3 years)
Your Phone (###) ###-####
(Required)
Type of employment desired (check all that apply)
(Required)
Full Time
Part Time
Temp
Seasonal
Select All
Are you legally allowed to work in the United States?
(Required)
Yes
No
Have you ever worked for this company before?
(Required)
Yes
No
Do you have a valid Driver's License?
(Required)
Yes
No
Have you ever been denied issue of a license, permit, or privledge to operate a motor vehicle?
(Required)
Yes
No
If yes, then explain (when?, details?)
Has any license, permit, or privledge ever been suspended or revoked?
(Required)
Yes
No
If yes, then explain (when?, details?)
Driver's License Class
(Required)
Class A CDL
Class B CDL
Class C CDL
Class D standard license
Driver's License
(Required)
State
License Number
Expiration Date
Add
Remove
In the past 2 years, have you failed or refused any DOT regulated drug or alcohol test?
(Required)
Yes
No
If yes, then explain
Endorsements
(Required)
Tanker
HAZMAT
Doubles/Triples
None
Class of Equipment
Complete any that are applicable below
Straight Trucks
Type (Van/Tanker/Flatbed,etc.)
Years of Experience
Add
Remove
Tractors; Semi-Trailer
Type (Van/Tanker/Flatbed,etc.)
Years of Experience
Add
Remove
Tractors; Two Trailers (Doubles)
Type (Van/Tanker/Flatbed,etc.)
Years of Experience
Add
Remove
Accident History
Include at least the last 3 years or more
1. Last Accident
Approximate Date
Nature of accident
Fatalities Y/N
Injuries Y/N
Add
Remove
2. Next Previous Accident
Approximate Date
Nature of accident
Fatalities Y/N
Injuries Y/N
Add
Remove
3. Next Previous Accident
Approximate Date
Nature of accident
Fatalities Y/N
Injuries Y/N
Add
Remove
Previous Employment
Note: If applying for a CMV/DOT position, the FMCSA requires that employment for the past 3 years AND/OR CMV experience for the past 10 years be shown.
Last Employer
Please complete all fields.
Last Employer
Company Name
Address
Phone
Position Held
Start date
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Was this position subject to FMCSA (DOT) regulations?
Yes
No
Was this position designated as safety sensitive, and subject to the drug and alcohol testing requirements of 49CFR, Part 40?
Yes
No
Second Last Employer
Second Last Employer
Company Name
Address
Phone
Position Held
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1920
Was this position subject to FMCSA (DOT) regulations?
Yes
No
Was this position designated as safety sensitive, and subject to the drug and alcohol testing requirements of 49CFR, Part 40?
Yes
No
Third Last Employer
Third Last Employer
Company Name
Address
Phone
Position Held
Start date
Month
Month
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1935
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1931
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1929
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End Date
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2019
2018
2017
2016
2015
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2012
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2010
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1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Was this position subject to FMCSA (DOT) regulations?
Yes
No
Was this position designated as safety sensitive, and subject to the drug and alcohol testing requirements of 49CFR, Part 40?
Yes
No
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