Employment Application

Please complete the following application:

Date:
Full Name:
Email:
Phone:
Address:
City, State, Zip:
Do you have transportation?	No Yes
Driver's License Issue:
Type of Driver's License	Operator Commercial (CDL)
Please list your work experience for your last/current job:
Name of Employer:
Job Title:
Address:
Phone:
Supervisor Name:
Employment Dates (from/to):
Pay or Salary:
Reason for Leaving (if applicable):
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:
May we contact your present employer?	No Yes

By "Submitting" this application I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or terminations of my employment.

I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with Delaney Resources creates an actual or implied contract of employment. I understand that, if I accept employment with Delaney Resources, it will be on an at-will basis. This means that Delaney Resources or I have the right to terminate the employment relationship at any time, for any reason, with or without cause.
I agree to submit to drug and alcohol testing, if requested by Delaney Resources. I release Delaney Resources and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing.

I authorize Delaney Resources to investigate information concerning my employment experiences and all other aspects of my background relevant to my proposed employment. I release Delaney Resources and its employees from all liability arising from such investigation.

I understand I will be required to provide a copy of my social security card and current driver's license, or other government issued identification, upon request.

Delaney Resources is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Delaney Resources depends solely on your qualifications.