Center Coal Co. North Dakota
701-794-3400
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Interested in a position at Baranko Bros?
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Personal Data
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Are You 18 Years or Older?
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Have You Been Employed With Baranko Bros,Inc. Before?
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Years of Education Completed
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In case of an emergency notify
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General Information
Position Applying For
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Date Able to Start
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Time and Days Available for Work
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Expected Wage (per hour)
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Equipment Operating Experience
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Type of Equipment
Years of Experience
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Driving Record Information
Drivers License No
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Endorsements
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No person will be considered for a position which requires the routine operation of a motor vehicle if any of the following offenses are shown on your Driving Record within the last two year period prior to the date of application: A) DUI or Actual Physical Control B) Reckless or Aggravated Driving C) Negligent Homicide or Manslaughter resulting from the Operation of a Motor Vehicle D) Driving Under Suspension or Revocation of Drivers License E) 3 or more Violations within the last 6 months, unless there have been No Other Violations for the past 12 months
Safety Training
MSHA-24 Hr.
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No
Date
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MSHA-8 Hr. Refresher
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Date
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OSHA 10 Hr
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No
Date
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List All Safety Training Received in the Last 5 Yrs. (Type and Date)
Drug Screening
Are You Willing To Take a Pre-Employment Drug Test?
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Yes
No
I fully understand that the presence of and/or use of Illegal Drugs may cause my rejection from further consideration for employment with Baranko Bros, Inc. I further understand that refusal to submit to a Drug Screening Test will constitute voluntary withdrawal of my Application for Employment.
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References
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Employment History
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Please include: Employer, Type of Business, Address, Job Title, Dates Employed (from - to), Phone Number, Duties Performed