APPLICATION FORM for employment with Patterson-UTI Drilling. (print clearly and complete in full)
POSI TI ON( S) APPLYI NG FOR
Personal I nformat ion
Legal Name:_____________________________________________________________________________________
Last |
First |
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Initial |
Mailing Address:__________________________________________________________________________________ |
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City/Town |
Province |
Home Phone:________________________________________ |
Alternate#________________________________ |
Do you have reliable transportation to and from work? (optional) |
Yes |
No |
Valid Driver’s License: (optional) |
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Yes |
No |
Coverall Size: |
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Are you legally able to work in Canada? |
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Yes |
No |
How did you hear about us? ________________________________________
Emergency Cont act
Name: ___________________________ Relationship: __________________________ Phone: _______________________________
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W ork Experience |
Rig Manager |
_________ Yrs________Mo’s |
Driller |
_________ Yrs________Mo’s |
Derrickman |
_________ Yrs________Mo’s |
Motorman |
_________ Yrs________Mo’s |
Floorhand |
_________ Yrs________Mo’s |
Leasehand |
_________ Yrs________Mo’s |
Type of Rig: |
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Size of Rig: |
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Previous Employers |
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Were you previously employed by Patterson-UTI Drilling (formerly Phelps Drilling)? |
Yes |
No |
Name: _________________________________________ |
______________________________________________ |
Position: _________________________________________ |
______________________________________________ |
Phone Number: ____________________________________ |
______________________________________________ |
Length of |
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Service: _________________________________________ |
______________________________________________ |
Valid Cert ificates
Are you enrolled in a Rig Technician Apprenticeship Program?
Yes 
No
If yes, what level have you completed?
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Floorhand Training |
Date Completed: |
Confined Space |
Expiry: |
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First Aid |
Expiry: |
Fall Protection |
Expiry: |
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Loader Certificate |
Expiry: |
Rig Rescue |
Expiry: |
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Boilers |
Expiry: |
TDG |
Expiry: |
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1st Line |
Expiry: |
H2S |
Expiry: |
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Certificate #: |
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Certificate #: |
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2nd Line |
Expiry: |
WHMIS |
Expiry: |
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I certify that all information contained in this application is true, complete and accurate. I understand that providing false information may result in no offer of employment or immediate dismissal.
I understand I will be on probation for the first three calendar months of my employment. At any time during this period, if Patterson-UTI Drilling deems it appropriate to terminate my employment for any reason, there is no obligation to pay severance pay.
I authorize Patterson-UTI Drilling to use this information, at their sole discretion, within the limits of the law. I also authorize Patterson-UTI Drilling to contact either my present or previous employers for references.
I understand that any offer of employment made by Patterson-UTI Drilling is conditional upon a satisfactory, job-related medical assessment and drug screen. I also understand the occupational requirements and certify that I am able to perform any physical requirements of the positions’ duties.
Submitting this form confirms your consent to the collection, retention, use and disclosure of your personal
information and work history as required for job selection, placement, training, payroll, and work bids for which you may be considered. Your information will be kept on file for the Company’s reference should you be considered for other employment with Patterson-UTI Drilling.
The job/position you are applying for is seasonal and/or based on specific projects. Section 55 of the Alberta Employment Standards Code authorizes an employer to terminate employment without notice at the completion of the drilling season or the completion of the well for which you are being hired.
Signature