Você está na página 1de 7

Lariat Services, nc., is a wholly owned subsidiary of SandRidge Energy.

We offer a great
benefits package including:
Competitive pay based on experience
Health, dental, life and disability insurance
401-K Retirement package with 100% match up to 15% of employee's wages
Safety incentive program
Longevity pay

To apply, fill out the application included in this file, then follow the instructions below:
For Texas Positions, FAX your application to: (432) 689-5394

For Oklahoma / Kansas Positions, FAX your application to: (580) 596-2269
OR Apply in person at:
Lariat Services (SandRidge Energy)
921 S. Ohio
Cherokee, OK 73728

SandRidge Energy nc. and all related subsidiaries (collectively, "SandRidge or the "Company), support equal
opportunity and will not discriminate, nor will the Company tolerate discrimination against any applicants or
employees on the basis of race, color, religion, creed, age, gender, sexual orientation, national origin, ancestry,
disability, or veteran status.



AppllcanL name: _____________________________________________ LasL lour of SSn: _____________

oslLlon Applylng lor: ______________________________________________ uaLe: __________________________


Sandk|dge Lnergy Inc. and a|| re|ated subs|d|ar|es (co||ect|ve|y, "Sandk|dge" or the "Company"), support equa|
opportun|ty and w||| not d|scr|m|nate, nor w||| the Company to|erate d|scr|m|nat|on aga|nst any app||cants or
emp|oyees on the bas|s of race, co|or, re||g|on, creed, age, gender, sexua| or|entat|on, nat|ona| or|g|n, ancestry,
d|sab|||ty, or veteran status.

Sand8ldge ls sub[ecL Lo cerLaln governmenLal recordkeeplng and reporLlng requlremenLs for Lhe admlnlsLraLlon of clvll
rlghLs laws and regulaLlons. ln order Lo comply wlLh Lhese laws, Lhe Company lnvlLes appllcanLs Lo volunLarlly self-
ldenLlfy Lhelr race or eLhnlclLy. Submlsslon of Lhls lnformaLlon ls volunLary and refusal Lo provlde lL wlll noL sub[ecL you
Lo any adverse LreaLmenL. 1he lnformaLlon obLalned wlll be kepL confldenLlal and may only be used ln accordance wlLh
Lhe provlslons of appllcable laws, execuLlve orders, and regulaLlons, lncludlng Lhose LhaL requlre Lhe lnformaLlon Lo be
summarlzed and reporLed Lo Lhe federal governmenL for clvll rlghLs enforcemenL. When reporLed, daLa wlll noL ldenLlfy
any speclflc lndlvldual.


Gender - Check one of Lhe followlng: Ma|e Iema|e

I choose not to se|f-|dent|fy

kace]Lthn|c Group - Check one of Lhe followlng:
n|span|c or Lat|no - A person of Cuban, Mexlcan, uerLo 8lcan, SouLh or CenLral Amerlcan, or oLher Spanlsh culLure or
orlgln regardless of race.
Wh|te (Not n|span|c or Lat|no) - A person havlng orlglns ln any of Lhe orlglnal peoples of Lurope, Lhe Mlddle LasL, or norLh
Afrlca.
8|ack or Afr|can Amer|can (Not n|span|c or Lat|no) - A person havlng orlglns ln any of Lhe black raclal groups of Afrlca.
Nat|ve nawa||an or Cther ac|f|c Is|ander (Not n|span|c or Lat|no) - A person havlng orlglns ln any of Lhe peoples of
Pawall, Cuam, Samoa, or oLher aclflc lslands.
As|an (Not n|span|c or Lat|no) - A person havlng orlglns ln any of Lhe orlglnal peoples of Lhe lar LasL, SouLheasL Asla, or Lhe
lndlan SubconLlnenL, lncludlng, for example, Cambodla, Chlna, lndla, !apan, korea, Malaysla, aklsLan, Lhe hlllpplne
lslands, 1halland, and vleLnam.
Amer|can Ind|an or A|aska Nat|ve (Not n|span|c or Lat|no) - A person havlng orlglns ln any of Lhe orlglnal peoples of norLh
and SouLh Amerlca (lncludlng CenLral Amerlca), and who malnLaln Lrlbal afflllaLlon or communlLy aLLachmenL.
1wo or More kaces (Not n|span|c or Lat|no) - A person who ldenLlfles wlLh more Lhan one of Lhe above flve races.
I choose not to se|f-|dent|fy


Vo|untary App||cant Se|f-Ident|f|cat|on

I





Employment Application
Date: ________________________





PERSONAL INFORMATION (Please print legibly)

Name: Telephone Number:

Email:


Present Address:
Street City State Zip

Permanent Address:
(if different) Street City State Zip

Social Security Number:

1. Position for which you are applying:

2. How were you referred to the Company?

3. Do you have any relatives who are presently (or have formerly been) employed by the Company? If so, please
Provide employee name(s) and Company name(s):



4. Are you at least 18 years of age or more? Yes No

5. Are you authorized to work in the U.S. on an unrestricted basis? Yes No

6. Have you previously worked for SandRidge or any related employer? Yes No

If yes, when?

7. Have you ever been convicted of a crime, pled no contest or been issued a deferred sentence? Yes No

If yes, please explain:



List any special skills/knowledge/qualifications that you have:






SandRidge Energy Inc. and all related subsidiaries (collectively, SandRidge or the Company), support equal opportunity and will not
discriminate, nor will the Company tolerate discrimination against any applicants or employees on the basis of race, color, religion, creed, age,
gender, sexual orientation, national origin, ancestry, disability, or veteran status.

I
I
I
I
age of 18 to do so case was deffered. It was a family trip cops were just concerned.
Enthusiastic, resourceful and enjoys challenges.
EDUCATION HISTORY

EDUCATION
LEVEL
NAME & LOCATION OF SCHOOL YEARS
COMPLETED
MAJOR DIPLOMA /
DEGREE

High School



College



Technical Training



EMPLOYMENT HISTORY
Please list all employment experience relevant to the position applied for. (Example: for Rig jobs, list Rig Experience.)

1. Current/most recent employer:

Company Name: Position Held:

Company Address:

Dates Employed: Supervisor:

Telephone Number: Salary:

Reason for Leaving:

2. Previous employer:

Company Name: Position Held:

Company Address:

Dates Employed: Supervisor:

Telephone Number: Salary:

Reason for Leaving:

3. Previous employer:

Company Name: Position Held:

Company Address:

Dates Employed: Supervisor:

Telephone Number: Salary:

Reason for Leaving:

NOTE: If necessary, attach a separate sheet of paper to list additional employers. We will contact all of the employers listed on this application
unless you specifically exclude below. Please list any employers you do not want us to contact and the reason below:


Employers Name Reason for Exclusion


Employers Name Reason for Exclusion
REFERENCES
Please do not include relatives, personal friends or employers already listed.

1. Name: Occupation: Years Known:

Address: Phone Number:

2. Name: Occupation: Years Known:

Address: Phone Number:

3. Name: Occupation: Years Known:

Address: Phone Number:


WORK AVAILABILITY

1. If your application receives favorable consideration, when would you be available to begin work?

2. Do you have any objection to working overtime? Yes No




I certify that the facts set forth in this Employment Application are true and complete to the best of my knowledge. I understand that if I am
employed by SandRidge, any false statements, omissions or misrepresentations may result in my dismissal. I authorize the Company to make an
investigation of any of the facts set forth in the application.

I authorize the Company to make and agree to cooperate in a thorough investigation of all statements made herein and other matters relating to
my background and qualifications. I understand that any investigation conducted may include a request for employment and educational history,
credit reports, consumer reports, driving record and criminal history. I authorize any person, school, current and past employer, consumer
reporting agency, and any other organization or agency to provide information relevant to such investigation. I hereby release all persons and
organizations requesting or supplying information pursuant to such investigation from all liability or responsibility to me for doing so.

I understand that I may be required to successfully pass a drug-screening examination. I hereby consent to a pre-employment drug screen as a
condition of my employment. If employed, I also agree to participate in the drug and alcohol testing program required by the Company.

I understand that employment at SandRidge is at-will; which means that I or the Company can terminate the employment relationship at any
time, with or without prior notice, and for any reason not prohibited by statute. All employment is conducted on that basis. I understand that no
supervisor or manager or executive officer of the Company, other than the Chief Executive Officer, has any authority to alter the foregoing.


Applicants Name (Please Print):

Applicants Signature:

Date:







Santa Monica odessa Tx
(432)260-8212
HCC manager
(209)349-2916
car sales man manager 10
(806)236-7140
Today.
I I
Bryan Villalobos
06/03/2014


LasL name* llrsL name* Mlddle name*

Malden and/or CLher LasL names used uaLe of 8lrLh* Soclal SecurlLy number*

Address* ClLy* SLaLe* Zlp Code

Llcense 1ype urlver Llcense number SLaLe of lssue LxplraLlon uaLe
1hls auLhorlzaLlon and consenL for release of personal lnformaLlon acknowledges LhaL Sand8ldge Lnergy, lnc. (hereafLer referred Lo as "Company")
and/or LmployeeScreenlC, may now conducL lnvesLlgaLlons wheLher Lhe records are of a publlc, prlvaLe or confldenLlal naLure. 1hese lnvesLlgaLlons
mlghL lnclude buL are noL llmlLed Lo:

LducaLlon verlflcaLlons. !!!!!!! #$%&'&() &* +,-+.-/0

Consumer CredlL 8eporLs. !!!!!!! #$%&'&() &* +,-+.-/0

8ecords from prevlous employmenL, lncludlng reference checks from prlor employers. !!!!!!! #$%&'&() &* +,-+.-/0

Crlmlnal PlsLory lnformaLlon. !!!!!!! #$%&'&() &* +,-+.-/0

8ecords from prevlous employmenL, lncludlng reference checks from prlor employers. !!!!!!! #$%&'&() &* +,-+.-/0

MoLor vehlcle drlvlng records and hlsLory. !!!!!!! #$%&'&() &* +,-+.-/0

l undersLand LhaL Lhese searches may be used Lo deLermlne work asslgnmenL or employmenL ellglblllLy and Lo verlfy lnformaLlon provlded Lo Lhe
Company durlng lLs appllcaLlon and screenlng process. 1herefore, l auLhorlze and consenL for full release of records (elLher orally or ln wrlLlng)Lo Lhe
auLhorlzed Company represenLaLlves boLh now and lf employed by Lhe Company, LhroughouL Lhe duraLlon of my employmenL as needed and wlLhouL
addlLlonal consenL. ln addlLlon, l release and dlscharge Lhe Company and lLs agenLs and assoclaLes as well Lhe appllcable parLy releaslng Lhe
lnformaLlon Lo Lhe full exLenL permlLLed by law from any clalms, damages, losses, llablllLles, cosLs expenses or any oLher charge or complalnL arlslng ouL
of or relaLed Lo reLrlevlng and obLalnlng Lhls lnformaLlon. l undersLand LhaL accordlng Lo Lhe lederal lalr CredlL 8eporLlng AcL, l am enLlLled Lo know
wheLher employmenL was denled based upon any consumer reporL obLalned and relled upon and l am enLlLled Lo recelve, upon wrlLLen requesL, a
dlsclosure of Lhe background reporL. l undersLand LhaL l may requesL a copy of Lhe reporL from LmployeeScreenlC, C 8ox 22627, Cleveland, CP
44122. AfLer readlng Lhls documenL, l fully undersLand lLs conLenLs and auLhorlze Lhe background verlflcaLlon.

lf you would llke Lo recelve a copy of Lhe consumer reporL, lf one ls obLalned, please check Lhls box and read below: lf you checked Lhe appllcable
box and you are a Callfornla appllcanL, a copy of Lhe consumer reporL wlll be senL wlLhln Lhree (3) days of Lhe employer recelvlng a copy of Lhe
consumer reporL. lor Callfornla appllcanLs only, lf publlc record lnformaLlon abouL your characLer, general repuLaLlon, personal characLerlsLlcs, and
mode of llvlng ls obLalned wlLhouL uslng a consumer reporLlng agency, you wlll be supplled a copy of Lhe publlc record lnformaLlon wlLhln seven (7)
days of Lhe employer's recelpL unless you check Lhls box. 8y checklng Lhls box you hereby walve your rlghL Lo obLaln any addlLlonal copy of Lhe
consumer reporL.
123 4()&*23%&(5 6&%%-72'(5 23 8.)(,29( (::)&+(%'7;

l PL8L8? CL81ll? 1PA1 ALL lnlC8MA1lCn 8CvluLu ln 1PlS Au1PC8lZA1lCn lS 18uL, CC88LC1 Anu CCMLL1L. l unuL8S1Anu1PA1 ll An?
lnlC8MA1lCn 8CvLS 1C 8L lnCC88LC1 C8 lnCCMLL1L 1PA1 C8CunuS lC8 1PL CAnCLLlnC Cl An? Anu ALL CllL8S WlLL LxlS1 Anu MA? 8L
uSLu A1 1PL SCLL ulSC8L1lCn Cl SAnu8luCL LnL8C?, lnC.


<&=%-/ ',&7 !!!!!!!!!!!!!!!!! /(> 2* !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!5 ?@!!!!!!!!!

A::)&+(%' #B3&%' C(9-0 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

A::)&+(%' <&=%('D3- !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Background Check Authorization

1202 rock Island
14
I
I
I
I
I
I
june



Drug and Alcohol Testing Consent Form


I, {Print Name}, understand that SandRidge Energy, Inc.
(the Company) is a drug and alcohol free workplace, and my employment is conditioned upon the
successful completion of the Company selected drug and alcohol screen.


EMPLOYEE CONSENT TO DRUG AND/OR ALCOHOL SCREENING:

I hereby agree to submit to any drug and/or alcohol test requested by the Company and to furnish a
sample of my urine, breath, hair, and/or blood for analysis. I understand and agree that if I at any time
refuse to submit to a drug and/or alcohol screen, or if I otherwise fail to cooperate with the screening
procedures, I may be denied employment.

I further authorize and give full permission to have the Company or the Companys contracted
testing entity send the specimen or specimens so collected to a laboratory for a screening test for
the presence of any prohibited substances, and for the laboratory or other testing facility to
release any and all documentation relating to such test to the Company and/or to any
governmental entity involved in a legal proceeding or investigation connected with the test.

Finally, I authorize the Company to disclose any documentation relating such testing and screening to
any governmental entity involved in a legal proceeding or investigation connected with the information.

I hereby release and will hold harmless the Company and each of its employees, officers, physicians,
testing laboratories, and other representatives the Company might use, meaning that I will not sue or hold
responsible such parties for any alleged claim of harm or other damages to me that might result from
such testing, or from such release of information, including without limitation, loss of employment or any
other kind of adverse job action that might arise as a result of the drug and/or alcohol screen, even if the
Company or any such other party makes an error in the administration or analysis of the test or the
reporting of the results.


UNDERSTOOD AND AGREED:


Applicant Name:
(Please Print)

Signature of Applicant: Date:

Você também pode gostar