Energy Laboratories Inc. :: Analytical Excellence Since 1952

Application for Employment
* Required fields are in red.

Date:	Home Phone:		Business Phone:	SSN:
Last Name:	First Name:		Middle:
Street/Mailing Address:		Email Address:
City:	State:	Zip:
Position Desired:
Would you like your application submitted for positions at our other laboratories? Yes No

Please check the appropriate locations:
(Check at least one.)

Billings, MT
Casper, WY
College Station, TX
Elko, NV
Gillette, WY
Helena, MT
Idaho Falls, ID
Rapid City, SD

Have you ever applied for employment with us before? Yes No
If yes: Month\Year	Location:
Pay Expected:	Full Time Part Time
Will you work overtime? Yes No
Will you work evening or weekend shifts? Yes No
Date available for work:

Are you legally eligible for employment in the United States? Yes No

Special Training or Skills (languages, machine operation, etc.)

How did you learn of our company?

Prospective employees will receive consideration without discrimination because of race, creed, national origin or handicap.

Employment History

Please give an accurate, complete, full/part-time employment record. Begin with your present or most recent employer.

1. Company Name	Phone Number
Address	Employment Period From: To:
Name of Supervisor	Salary/Wage per year/hour
State job title and describe your work	Reason for leaving

2. Company Name	Phone Number
Address	Employment Period From: To:
Name of Supervisor	Salary/Wage per year/hour
State job title and describe your work	Reason for leaving

3. Company Name	Phone Number
Address	Employment Period From: To:
Name of Supervisor	Salary/Wage per year/hour
State job title and describe your work	Reason for leaving

May we contact the above listed employers? Yes No (If no, do not contact: 1 2 3 )
Reason for not contacting:
	I hereby certify that this application contains no willful misrepresentations or falsifications, and the information given by me is true and complete to the best of my knowledge.