EmailMe Form - Master Rig International, LLLP

As part of the application process, MRI, LLLP may conduct background checks on applicants.

EQUAL OPPORTUNITY EMPLOYER. It is our policy to abide by all federal, state and local laws prohibiting employment
discrimination solely on the basis of a person’s race, religious creed, color, national origin, ancestry, physical disability, mental
disability, medical condition (including, but not limited to, cancer related or HIV related), marital status, sex, gender (including sex
stereotyping), age, sexual orientation, military status, or any other protected status except where a reasonable, bona fide
occupational qualification exists.

Today's Date

Name *

Prefix First Last Suffix

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Home Number *

### - ### - ####

Cell Number *

### - ### - ####

Email Address

Are you eligible to work in the United States? *

Yes

No

If you are under age 18, do you have an employment/age certificate? *

Yes

No

If yes, please explain:

POSITION/AVAILABILITY:

Position Applied For *

Days Available *

Hours Available *

AM

PM

Graveyard

For specific Day/Hour availability, please enter information below.

What date are you available to start work? *

MM / DD / YYYY

EDUCATION:

Name and Address Of School - Degree/Diploma - Graduation Date *

Skills and Qualifications: Licenses, Skills, Training, Awards *

EMPLOYMENT HISTORY:

Present Or Last Position:

Employer: *

Address: *

Supervisor: *

Phone Number *

### - ### - ####

Email

Position Title: *

Start Date *

MM / DD / YYYY

End Date *

MM / DD / YYYY

Responsibilities: *

Salary *

Input hourly wage, if not salaried.

Reason for Leaving: *

Previous Position

Employer: *

Address: *

Supervisor: *

Phone Number *

### - ### - ####

Email

Position Title: *

Start Date *

MM / DD / YYYY

End Date *

MM / DD / YYYY

Responsibilities: *

Salary *

Input hourly wage, if not salaried.

Reason for Leaving: *

May We Contact Your Present Employer? *

Yes

No

References:
Name/Title Address Phone *

I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my
knowledge. I also agree that falsified information or significant omissions may disqualify me from further consideration for employment and may
be considered justification for dismissal if discovered at a later date.

I authorize all persons listed above (and on the accompanying resume, if any) to give MRI any and all information concerning my previous
employment and education and any pertinent information they may have, personal or otherwise, and release all parties, such persons and
MRI, from liability for any damage that may result from furnishing same to MRI.

I understand that MRI have agreed that MRI will provide workers’ compensation insurance coverage for its employees.
In the event of an injury in the workplace, I agree that my sole remedy lies in coverage under MRI’s workers’ compensation insurance policy.

If employed by MRI, I agree to abide by the policies and procedures of MRI, which include MRI’s Anti-Harassment Policy. I further understand that my employment can be terminated, with or without cause or notice, at any time, at the discretion of MRI myself. I further understand that no manager or representative of MRI other than the president of MRI has any authority to enter into any agreement, oral or written, on behalf of MRI
for a term of employment or to make any assurance or promise of continued employment.

I understand that MRI may obtain a consumer and/or investigative consumer report for employment purposes that may include information regarding prior employment, work experience and performance, reasons for employment termination, and information as to character, general reputation, personal characteristics, or mode of living. The report may also contain a records check of driving, criminal, credit, education, degrees, professional licenses and/or certification records depending on the position. By signing this application, I authorize the procurement of a consumer and/or investigative consumer report by MRI as part of the pre-employment background investigation and if hired, at any time during my employment.

I understand and agree that I may be required to take a drug and alcohol screening test. I hereby give my voluntary consent for a blood and/or
urine sample to be collected from me and submitted for testing. I also consent to the release of the test result to MRI for its use. I understand
that any positive drug or alcohol result may preclude my employment.

Do you agree with the terms and conditions? *

Yes, I agree.

Initial *

Date *

MM / DD / YYYY