Job Application Form | O&G Exploration & Production

Personal Data

	* Required Fields
Requisition ID
* First Name
* Last Name
Middle Initial
Known as/Goes by
* Street Address
* City
* State
* Zip (5 digit)
* Phone	- -
Alternate Phone	- -
Email

Personal Data (continued)

* Required Fields

* Social Security Number

- -

How did you learn
about us?

	State Employment Service
	Advertisement
	College/Recruiting
	Employee (Name):
	Web Site (Enter URL Here):
	Other:

Type of Work Desired


Position Applied For
Acceptable Beginning Salary $ (numbers only, no dollar signs or commas)
Preferred Company Location

General Information

* Required Fields

* Are you available to work
(Check all that apply)

	Full Time
	Part Time
	Shift Work
	Temporary

* Hours Available
(Check all that apply)

	Days
	Evenings
	Weekends
	Any

*What date can you
begin work?

*Can you furnish proof of your legal right to work in the United States?
Proof of citizenship or Immigration status will be required upon employment, along with I-9 form.

Yes No

* Are you under 18
years of age?

Yes No

* If so, can you provide required proof of your eligibility to work?

Yes No

*Are you currently employed?

Yes No

*Are you, or do you anticipate being, related by blood or marriage to anyone now employed by Energen?

Yes No

What is the name of the person you are related to?

How are you related to this person?

*Have you ever been employed with Energen or any of its subsidiary companies?

Yes No

* If yes, give dates of employment.

From
To

Reason for Leaving

General Information (continued)

	* Required Fields
* Have you ever been convicted of, pleaded guilty to, received probation or been placed on any form of diversion program (e.g., community service or education requirements in lieu of a sentence for jail time) for any offense (misdemeanors or felonies)?	Yes No
If yes, describe fully, including dates, criminal offenses, location (city and state) and disposition. Conviction will not necessarily disqualify an applicant from employment.	Please Explain
* If your answer to the above question is no, are there any such actions pending?	Yes No
If yes, describe fully, including dates, criminal offenses, location (city and sate) and disposition.	Please explain

Employment Data

Begin with present or most recent position. In listing dates, give month and year.

	* Required Fields
Job #1
* May we contact your former or current employer?	Yes No
* Employer
Phone	- -
Street Address
City
State
Zip
Job Title
Supervisor
* Dates Employed (If currently employed with this company, enter current month/year)	From To
Salary $	Start End
* Work Performed (500 character limit)	characters left
* Reason for Leaving (If currently employed with this company, enter N/A)
Note: If break between jobs, please explain.

Job #2
* Employer
Phone	- -
Street Address
City
State
Zip
Job Title
Supervisor
* Dates Employed (If currently employed with this company, enter current month/year)	From To
Salary $	Start End
* Work Performed (500 character limit)	characters left
* Reason for Leaving (If currently employed with this company, enter N/A)
Note: If break between jobs, please explain.

Job #3
* Employer
Phone	- -
Street Address
City
State
Zip
Job Title
Supervisor
* Dates Employed	From To
Salary $	Start End
* Work Performed (500 character limit)	characters left
* Reason for Leaving
Note: If break between jobs, please explain.

Job #4
* Employer
Phone	- -
Street Address
City
State
Zip
Job Title
Supervisor
* Dates Employed	From To
Salary $	Start End
* Work Performed (500 character limit)	characters left
* Reason for Leaving
Note: If break between jobs, please explain.

Please click the button to the right to provide additional job history information. You may enter up to four additional listings.

Educational Data

School #1

* Level of Education Completed
(Add highest level of education first)

	GED
	High School
	Some College
	Associate
	Undergraduate
	Graduate
	Post-Graduate
	Technical
	Other:

* School Name

* School Location

* Diploma/Degree

Yes No

Type of Degree

Estimated Graduation/
Graduation Date

Major/Minor

Grade Point Average

To add additional education experience, click here

Military Data (if applicable)


Branch of Service
Dates of Service	From To
Have you ever had any job-related training in the United States Military?	Yes No
If yes, please describe	not applicable

Special Skills and Qualifications (if applicable)


Summarize special job-related skills and qualifications acquired from employment or other experience.
List typing speed and software packages that you have used, if applicable.

Honors and Activities (if applicable)


List all honors, civic, social and professional activities during your school and professional careers. You may omit those that indicate race, color, religion, age, sex, national origin, marital status, disability or veteran status.

Resume

	If you have additional information, experience or employment history not previously covered in your application which is relevant to the vacancy for which you are applying, please enter here or cut and paste your resume below.
Cut & Paste Your Resume Here

Certification and Agreement

As an applicant for employment with Energen,

I understand that, if employed, my employment is not guaranteed for any term and that my employment may be terminated by the Company or myself at any time for any reason. No management official is authorized to make any oral assurance or promise of continued employment.
I certify that all information given on this application and accompanying documentation is true and correct.
I understand that any misrepresentation or falsification of information or material omission will be cause for rejection of my application or for subsequent discipline up to and including my dismissal from employment if discovered at a later date.
I understand that my employment is contingent upon the results of a drug screening analysis for substance abuse. The results of such analysis may be grounds for disqualifying me or terminating my employment. I also realize Energen’s Substance Abuse Policy includes random testing during employment.
I understand that the possession of contraband (weapons, alcohol, illegal drugs, etc.) on the job or company premises will result in immediate discipline, up to and including termination of employment. I also hereby consent to any searches of my property or person in order to enforce the prohibition against contraband.
If my application for employment is accepted, the effective date of my employment shall be the time I actually begin to work. If I am employed, I agree to comply with and be bound by Energen’s policies, practices, safety, and health rules.
I understand that computers, electronic messages (e-mail), voice mail and phone messages are the property of Energen, and I have no expectation of privacy concerning internal communication sources. I understand that my use of these means of communication may be monitored by Energen and I consent to such monitoring.
I understand inventions and intellectual property belong to Energen. Trade secrets and proprietary information belong to Energen. Information and inventions which I access or develop as a result of my employment with Energen will not be used as a business advantage, or otherwise disclosed to any other person or entity, if I were to leave the employment of Energen.
I hereby give Energen the right to make a thorough investigation of my past employment, education, and activities, and release from all liability all persons, schools, companies, and other entities supplying such information. I indemnify Energen against any liability that might result from making such investigation and acknowledge that the results of such investigation may be grounds for disqualifying me or terminating my employment.
I understand that my employment is conditional upon my ability to perform the essential functions of the job I am offered with or without accommodation.
I hereby authorize ENERGEN and/or its agents to prepare or request a Consumer Report on me. I understand that this information may be used for employment purposes and/or obtaining information which may be material to my qualification for employment. I understand that if an investigative consumer report is requested or compiled, I have a right to request a complete disclosure of the nature and scope of the investigation requested. I also understand that if a consumer report is requested on me, I will receive a written summary of my rights under the Fair Credit Reporting Act.

I have read and fully understand the contents of the Certification and Agreement section.

Completion Confirmation

Thank you for completing this application. We hope that the online application process with Energen has been a pleasant one. Qualified applicants will be contacted.

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