New Employee Candidate Information Name Contact # SSN#
Status Contacted Interviewed Interviewed by Hire
Date
Yes / No
Position considered for:
Referred by:
Employee Resume Drop
Employment Application Completed (attach to the back of this form) References checked Contact History Date
Current CDL?
YES / NO
Discussed
New Employee Tasks Scheduled Date Office for Paperwork Request DOT background check 5 yr DMV records req from applicant & recvd Drug Test & Medical DOT/DMV Review, Medical Review & Offer Made Yes / No NSTC Training Position Title/ Location Alternate (if known) Initial Flight Regular Rotation Notify HSE for Orientation PSTS/Billeting Done Completed Sheet Distribution: Copy for electronic File (Kuparuk Safety) Original to Personnel File (Payroll)
Info
Pass
/ Fail
PRB / KUP
5/30/2008
