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Matrix

Matrix Well Servicing Employment Application Form

Position Applying For

Last Name

First Name

Middle Name

Address

City

Prov

Postal Code

Home Phone

Cell Phone

Have You Ever:

Been interviewed by Stoneham?
If yes, Rig#
Date
Applied to Stoneham?
If yes, Rig#
Date
Been employed by Stoneham?
If yes, Rig#
Date

Employment Logistics
I Am 18 Or Older		I Am Entitled To Work In This Country
Are there any limitations that would prevent you from doing this job?		I am able to work away from home (i.e. out of town)
Were you referred by a current Stoneham employee?		Who referred you?
Additional Comments

Previous Employment Experience
Employer Name & Location	Employer Ph # Incl Area Code	Position Held	Reason for leaving	Size of Rig

From To

From To

From To

From To

Competency/Education
Highest Level Of Education	Rig Tech Level Completed	Date Completed

Industry Specific Training/Certifications
Certificate	Certificate #	Expiry Date
Well Service Bop
Oilfield Boilers
Crane Operator Training
Rig Orientation
WHMIS
Respirator Fit Testing
Incident Investigation
Picker Training
Gas Detector Training
Standard First Aid and CPR
H₂S Alive
Fall Protection
Rig Rescue
Audiometric Hearing Test
Confined Space
Other

References
Employer Name & Location	Employer Ph # Incl Area Code	Reference Name	Reference Title

Attach Files
To attach your resume, cover letter and/or copies of current training certificates or tickets to your application, please select them from your computer using the provided fields. Allowable file types: text, PDF, DOCX, PPT Maximum file size: 5MB
Select File 1
Select File 2
Select File 3

Notice to All Applicants
The position you are applying for is seasonal or is based on specific projects. Section 55(2) of the Alberta Employment Standards Code authorizes an employer to terminate your employment without further notice or payments in lieu of notice at: The completion of the drilling season; The completion of the well for which you are being hired; Continued employment is or has become impossible for the employer to perform because of unforeseeable or unpreventable causes beyond our control, e.g. poor drilling results, decline in the price of crude oil, wet weather etc.
Safety Regulations/Disclaimer
I understand that failure to comply with the safety regulations of this company and relevant governments are grounds for dismissal. I agree to participate in any safety courses offered by the Company. I certify that the statements made in this application are true and correct. I understand that a false statement may result in disqualification from employment, or termination with just cause. I understand and agree that unless otherwise noted, Matrix Well Servicing will contact my previous employers for an employment reference. I understand that Matrix Well Servicing requires pre-employment physical and audio testing, and that I will be required to take a drug and alcohol test as a condition of my employment.

Notice to All Applicants

The position you are applying for is seasonal or is based on specific projects. Section 55(2) of the Alberta Employment Standards Code authorizes an employer to terminate your employment without further notice or payments in lieu of notice at:

The completion of the drilling season;
The completion of the well for which you are being hired;
Continued employment is or has become impossible for the employer to perform because of unforeseeable or unpreventable causes beyond our control, e.g. poor drilling results, decline in the price of crude oil, wet weather etc.

Safety Regulations/Disclaimer

I understand that failure to comply with the safety regulations of this company and relevant governments are grounds for dismissal. I agree to participate in any safety courses offered by the Company.
I certify that the statements made in this application are true and correct. I understand that a false statement may result in disqualification from employment, or termination with just cause.
I understand and agree that unless otherwise noted, Matrix Well Servicing will contact my previous employers for an employment reference.
I understand that Matrix Well Servicing requires pre-employment physical and audio testing, and that I will be required to take a drug and alcohol test as a condition of my employment.