RMARLEY LLC EMPLOYMENT APPLICATION

R. Marley, LLC. is currently seeking applicants to fill available positions. R. Marley, LLC. is a leader in oilfield logistics, providing safe and reliable service to customers throughout the Permian Basin. In order to be considered for a position, please be sure to fill out the entire application as completely and accurately as possible.

Personal Information

First Name (As appears on DL) *

Last Name (As appears on DL) *

Address 1 *

Address 2

City *

State *

Zip Code *

Driver's License Number *

Social Security Number *

Date of Birth *

I give authorization for R. MARLEY, LLC. and Leavitt Group Southwest, Inc. to obtain a current copy of my Motor Vehicle Driving Record (MVR). I state that I currently hold a valid Motor Vehicle Driver's license as indicated below and all information is correct. This authorization is good until revoked by me in writing. This information will only be used to verify my MVR for employment and insurance qualification. *

I Agree to the above statement

Phone *

Email Address *

Position Applying For *

Are you legally authorized to work in the United States? *

Yes

Have you ever been convicted of a felony? *

Yes

If yes, please explain.

Driver Qualifications

Have you ever been denied a license, permit or privilege to operate a motor vehicle? *

Yes

Has any license, permit or privilege ever been revoked? (If Yes, attach a statement giving details.) *

Yes

Please Provide a list of Moving Traffic Convictions & Forfeitures fur the past 3 years. Include Date, Offense, Location and Type of Motor Vehicle Operated. *

This Company requires all Drivers who operate Commercial Motor Vehicles (CMV) which require a Commercial Driver's License (CDL), to be tested for controlled substances with a negative result prior to driving. Do you consent to such testing? *

Yes

Employment History (Past 3 years and Commercial Driving for past 10 years)

Employer 1

Company Name *

Address

Phone

Start Date +

End Date +

Position

Salary

Supervisor/Manager

Reason for Leaving

May we contact? *

Yes

Phone Number

Employer 2

Company Name

Address

Phone

Start Date +

End Date +

Position

Salary

Supervisor/Manager

Reason for Leaving

May we contact? *

Yes

Phone Number

Employer 3

Company Name

Address

Phone

Start Date +

End Date +

Position

Salary

Supervisor/Manager

Reason for Leaving

May we contact? *

Yes

Phone Number

References

Reference 1

Name

Title

Email Address

Phone

Reference 2

Name

Title

Email Address

Phone

Reference 3

Name

Title

Email Address

Phone

Additional Skills

List any additional skills that you would like to mention.

Please submit a copy of your resume.

All information is true and correct to the best of my knowledge. *

clear