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Have you ever been an employee of Western Land Services? *

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Have you ever been an Independent Contractor or Vendor for Western Land Services? *

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What type of work are you interested in (check all that apply) *

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Willingness to Travel *

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Less than 10%

10% - 25%

25% - 50%

Road Warrior

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Are you age 18 or older? *

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Are you legally eligible to work in the United States? *

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Will you now, or in the future, require sponsorship for employment visa status (e.g. H-1B visa status)? *

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Have you ever been convicted of a crime? (Residents of California, Colorado, Connecticut, Washington D.C., Hawaii, Illinois, Massachusetts, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, may consult state law regarding current applicant conviction reporting requirements) *

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Choose not to disclose based on applicable state law

If you selected yes for the question above, please list the Offense, Year Convicted, and any additional information

Additional Information (optional) --- U.S. Equal Employment Opportunity Information (Completion is Voluntary) Individuals seeking employment at Western Land Services are considered without regards to race, color, religion, sex, sexual orientation, gender identification, national origin, age, marital status, ancestry, physical or mental disability, or veteran status. You are being given the opportunity to provide the following information in order to help us comply with federal and state Equal Employment Opportunity record keeping, reporting, and other legal requirements. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file. Please select below if you wish to share this information

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Race

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Veteran Status

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I understand that Western Land Services, Inc. (from here on referred to as "Western") will rely, in part, on the information I provide in this Employment Application in considering whether to hire me. I understand that it is important that I provide complete and accurate information and certify that I have done so. If Western discovers at any time that I failed to completely and honestly provide any information requested of me in this Employment Application or during the interview process, I understand that my application will no longer be considered or, if I am working for the organization, that I will be subject to disciplinary action, up to and including termination of employment. Western is committed to compliance with the provisions of this nation’s immigration laws regarding verification of employment eligibility. Any offer of employment will be contingent upon your ability to provide legally sufficient documentation showing your eligibility to be employed by this organization. Applicants or employees that present fraudulent documents for employment verification purposes will be terminated. I authorize Western to contact anyone that it deems appropriate to verify the information I have provided or to further investigate my background, past performance and suitability for employment. I consent to being discussed by any person contacted by the organization and waive all rights to bring any action for defamation, invasion of privacy or any similar claim against anyone that provides information to Western with a good faith belief that the information provided is true. I understand that Western may choose to obtain background information about me from a consumer reporting agency. Before requesting a report from a consumer reporting agency, Western will ask for my authorization. I understand that if I refuse to provide such authorization, my application for employment will not be considered. I understand that this Employment Application is not an offer of employment. I understand that nothing contained in this Employment Application creates a contract between Western and me for employment or any other benefit. No promises regarding employment have been made and I understand that no such promise or guarantee is binding upon the organization. I understand that if I am hired, I will be an employee "at will," meaning I am not hired for any definite length of time and either I or the organization can terminate my employment at any time for any or no reason. If employed, I understand and agree that the organization retains the sole right in its business judgment to modify, suspend, interpret, or cancel, in whole or in part, at any time, with or without any notice, any published or unpublished policy, practice, procedure, process, or benefit. If employed, I understand that I may be required to comply with federal and/or state Drug Free Workplace Laws and regulations. I understand and agree to comply with such laws. If employed, I understand that as a condition of employment that I may be required to agree to and sign the organization’s confidentiality, non-compete, and/or other similar agreements. I also agree to notify the organization during the pre-employment process of any confidentiality, non-compete, and/or other similar agreements that I may have already signed with current and/or former employers, or other potential conflict. I understand that the technical processing and transmission of the application, including my personal information, may involve (a) transmissions over various networks, including the transfer of this information to the United States and/or other countries for storage, processing and use by Western Land Services, its affiliates, and their agents; and (b) changes to conform and adapt to technical requirements of connecting networks or devices. Accordingly, I agree to permit such parties to make such transmissions and changes, and hereby provide the necessary consent for the same. Initial to agree and affirm that all of the above statements are true to the best of your knowledge and abilities.* *

Job Application Form

GIS Data Analyst

Western Land Services Inc

GIS

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