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krymson
May 22nd, 2014
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  1. <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
  2. <html xmlns="http://www.w3.org/1999/xhtml">
  3. <head>
  4. <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
  5. <title>M&amp;D Foundation Drilling Industries, Inc.</title>
  6. <link href="css/template.css" rel="stylesheet" type="text/css" />
  7. <script src="Scripts/swfobject_modified.js" type="text/javascript"></script>
  8. <script>
  9. var timeout = 500;
  10. var closetimer = 0;
  11. var ddmenuitem = 0;
  12.  
  13. // open hidden layer
  14. function mopen(id)
  15. {
  16. // cancel close timer
  17. mcancelclosetime();
  18.  
  19. // close old layer
  20. if(ddmenuitem) ddmenuitem.style.visibility = 'hidden';
  21.  
  22. // get new layer and show it
  23. ddmenuitem = document.getElementById(id);
  24. ddmenuitem.style.visibility = 'visible';
  25.  
  26. }
  27. // close showed layer
  28. function mclose()
  29. {
  30. if(ddmenuitem) ddmenuitem.style.visibility = 'hidden';
  31. }
  32.  
  33. // go close timer
  34. function mclosetime()
  35. {
  36. closetimer = window.setTimeout(mclose, timeout);
  37. }
  38.  
  39. // cancel close timer
  40. function mcancelclosetime()
  41. {
  42. if(closetimer)
  43. {
  44. window.clearTimeout(closetimer);
  45. closetimer = null;
  46. }
  47. }
  48.  
  49. // close layer when click-out
  50. document.onclick = mclose;
  51. </script>
  52. <style type="text/css">
  53. <!--
  54. body {
  55. background-color: #000;
  56. }
  57. -->
  58. </style>
  59. <script language='JavaScript' type='text/javascript' src='JScript/formValidator.js'></script>
  60. <script>
  61. function validate(formNode){
  62. var formValidatorInstance = new FormValidator(formNode);
  63. formValidatorInstance.addRule('First_Name','First Name Required','required');
  64.  
  65. formValidatorInstance.addRule('Last_Name','Last Name Required','required');
  66.  
  67. formValidatorInstance.addRule('Home_Phone','Home Phone Required','required');
  68.  
  69. formValidatorInstance.addRule('agreement','You must certify that all the information submitted is true.','ischecked');
  70. return formValidatorInstance.validate();
  71. }
  72. </script>
  73. </head>
  74.  
  75. <body>
  76.  
  77.  
  78. <div id="container">
  79. <div id="header">
  80.  
  81. <object id="FlashID" classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" width="1024" height="428">
  82. <param name="movie" value="flash/intro_video.swf" />
  83. <param name="quality" value="high" />
  84. <param name="wmode" value="opaque" />
  85. <param name="swfversion" value="6.0.65.0" />
  86. <!-- This param tag prompts users with Flash Player 6.0 r65 and higher to download the latest version of Flash Player. Delete it if you don’t want users to see the prompt. -->
  87. <param name="expressinstall" value="Scripts/expressInstall.swf" />
  88. <!-- Next object tag is for non-IE browsers. So hide it from IE using IECC. -->
  89. <!--[if !IE]>-->
  90. <object type="application/x-shockwave-flash" data="flash/intro_video.swf" width="1024" height="428">
  91. <!--<![endif]-->
  92. <param name="quality" value="high" />
  93. <param name="wmode" value="opaque" />
  94. <param name="swfversion" value="6.0.65.0" />
  95. <param name="expressinstall" value="Scripts/expressInstall.swf" />
  96. <!-- The browser displays the following alternative content for users with Flash Player 6.0 and older. -->
  97. <div>
  98. <h4>Content on this page requires a newer version of Adobe Flash Player.</h4>
  99. <p><a href="http://www.adobe.com/go/getflashplayer"><img src="http://www.adobe.com/images/shared/download_buttons/get_flash_player.gif" alt="Get Adobe Flash player" width="112" height="33" /></a></p>
  100. </div>
  101. <!--[if !IE]>-->
  102. </object>
  103. <!--<![endif]-->
  104. </object>
  105. </div>
  106. <div id="navbar">
  107. <ul id="sddm">
  108. <li><a href="index.html">Home</a></li>
  109. <li><a href="about_us.html">About Us</a></li>
  110. <li><a href=""
  111. onmouseover="mopen('m2')"
  112. onmouseout="mclosetime()">Services</a>
  113. <div id="m2"
  114. onmouseover="mcancelclosetime()"
  115. onmouseout="mclosetime()">
  116. <a href="open_hole_drilling.html">Open Hole Drilling</a>
  117. <a href="cased_drilling.html">Cased Drilling</a>
  118. <a href="rock_drilling.html">Rock Drilling</a>
  119. <a href="slurry_displaced_drilling.html">Slurry Displaced Drilling</a>
  120. <a href="specialty_drilling.html">Specialty Drilling</a>
  121. <a href="other_services.html">Other Services</a>
  122. </div>
  123. </li>
  124. <li><a href="equipment.html">Equipment</a></li>
  125. <li><a href="photo_gallery.html"> Photo Gallery</a></li>
  126. <li><a href="employment.html"> Employment</a></li>
  127. <li style=" border:none;"><a href="contact_us.html"> Contact Us</a></li>
  128. </ul>
  129. <div style="clear:both"></div>
  130. </div>
  131. <div id="content_container">
  132. <div id="content">
  133. <form action="/HDWForm2Mail/Form2Mail.php" method="post" onsubmit="return validate(this)" accept-charset="iso-8859-1">
  134. <table border="0" width="958" height="79" cellspacing="0" cellpadding="4">
  135. <tr>
  136. <td height="23" width="932" bgcolor="#601e05" colspan="4"><input type="text" name="date" size="20" />
  137. &nbsp; Date:</td>
  138. </tr>
  139. <tr>
  140. <td height="23" width="187"><input type="text" name="First_Name" size="20" />
  141. <br />
  142. First</td>
  143. <td height="23" width="195"><input type="text" name="Middle_Name" size="20" />
  144. <br />
  145. Middle</td>
  146. <td height="23" width="188"><input type="text" name="Last_Name" size="20" />
  147. <br />
  148. Last</td>
  149. <td height="23" width="358">&nbsp;</td>
  150. </tr>
  151. <tr>
  152. <td height="23" width="387" colspan="2" bgcolor="#601e05"><input type="text" name="Home_Address" size="48" />
  153. <br />
  154. Home Address</td>
  155. <td height="23" width="188" bgcolor="#601e05"><input type="text" name="City" size="20" />
  156. <br />
  157. City</td>
  158. <td height="23" width="358" bgcolor="#601e05"><input type="text" name="Zip" size="20" />
  159. <br />
  160. Zip</td>
  161. </tr>
  162. </table>
  163. <table border="0" width="958" height="54" cellspacing="0" cellpadding="4">
  164. <tr>
  165. <td height="23" width="278"><input type="text" name="Home_Phone" size="20" />
  166. <br />
  167. Home Phone</td>
  168. <td height="23" width="299"><input type="text" name="Social_Security" size="20" />
  169. <br />
  170. Social Security</td>
  171. <td height="23" width="354"><input type="text" name="DL_Number" size="20" />
  172. <br />
  173. Drivers License Number</td>
  174. </tr>
  175. <tr>
  176. <td height="23" width="278" bgcolor="#601e05"><input type="text" name="Cell_Phone" size="20" />
  177. <br />
  178. Cell Phone</td>
  179. <td height="23" width="299" bgcolor="#601e05"><input type="text" name="DOB" size="20" />
  180. <br />
  181. Date Of Birth</td>
  182. <td height="23" width="354" bgcolor="#601e05"><input type="text" name="State_Issue_Class" size="20" />
  183. <br />
  184. State Of Issue/Class</td>
  185. </tr>
  186. </table>
  187. <table border="0" width="958" height="54" cellspacing="0" cellpadding="4">
  188. <tr>
  189. <td height="23" width="278"><input type="text" name="Position_Desired" size="20" />
  190. <br />
  191. Position Desired</td>
  192. <td height="23" width="302"><input type="text" name="Salary_Desired" size="20" />
  193. <br />
  194. Salary Desired</td>
  195. <td height="23" width="354"><input type="text" name="Start_Date" size="20" />
  196. <br />
  197. Date You Can Start?</td>
  198. </tr>
  199. <tr>
  200. <td height="23" width="278" bgcolor="#601e05"><input type="text" name="How_Did_You_Hear_About_Us" size="20" />
  201. <br />
  202. How Did you Hear of Us?</td>
  203. <td height="23" width="302" bgcolor="#601e05"><input type="text" name="Previous_Compensation" size="20" />
  204. <br />
  205. Compensation of Last Job?</td>
  206. <td height="23" width="354" bgcolor="#601e05">&nbsp;</td>
  207. </tr>
  208. </table>
  209. <table border="0" width="958" height="333" cellspacing="0" cellpadding="4">
  210. <tr>
  211. <td height="25" width="457">Are
  212. you 18 years of age or older?</td>
  213. <td height="25" width="125">YES
  214. <input type="radio" value="Yes" name="Are_you_18" /></td>
  215. <td height="25" width="354">NO
  216. <input type="radio" value="No" name="Are_you_18" /></td>
  217. </tr>
  218. <tr>
  219. <td height="16" width="457" bgcolor="#601e05">Have
  220. you ever had an &quot;At Fault&quot; accident while on the job? </td>
  221. <td height="16" width="125" bgcolor="#601e05">YES
  222. <input type="radio" value="Yes" name="At_Fault_Accident" /></td>
  223. <td height="16" width="354" bgcolor="#601e05">NO
  224. <input type="radio" value="No" checked name="At_Fault_Accident" /></td>
  225. </tr>
  226. <tr>
  227. <td height="23" width="457">If
  228. yes, explain:</td>
  229. <td height="23" width="479" colspan="2"><input type="text" name="Explain_Accident" size="43" /></td>
  230. </tr>
  231. <tr>
  232. <td height="23" width="457" bgcolor="#601e05"> Number of speeding tickets in the last 3 years?</td>
  233. <td height="23" width="479" colspan="2" bgcolor="#601e05"><input type="text" name="Number_Of_Speeding_Tickets" size="43" /></td>
  234. </tr>
  235. <tr>
  236. <td height="25" width="457">Have
  237. you ever been injured on the job?</td>
  238. <td height="25" width="125">YES
  239. <input type="radio" value="Yes" name="Injured_on_job" /></td>
  240. <td height="25" width="354">NO
  241. <input type="radio" value="No" checked name="Injured_on_job" /></td>
  242. </tr>
  243. <tr>
  244. <td height="23" width="457" bgcolor="#601e05">What
  245. was the outcome of your injuries?</td>
  246. <td height="23" width="479" colspan="2" bgcolor="#601e05"><input type="text" name="Outcome_Of_injuries" size="43" /></td>
  247. </tr>
  248. <tr>
  249. <td height="40" width="457">Are
  250. you prevented from becoming lawfully employed due to immigration status?</td>
  251. <td height="40" width="125">YES
  252. <input type="radio" value="Yes" name="prevented_to_work_lawfully" /></td>
  253. <td height="40" width="354">NO
  254. <input type="radio" value="No" name="prevented_to_work_lawfully" /></td>
  255. </tr>
  256. <tr>
  257. <td height="23" width="457" bgcolor="#601e05">Have
  258. you ever been convicted of a felony?</td>
  259. <td height="23" width="125" bgcolor="#601e05">YES
  260. <input type="radio" value="Yes" name="Convicted_of_Felony" /></td>
  261. <td height="23" width="354" bgcolor="#601e05">NO
  262. <input type="radio" value="No" name="Convicted_of_Felony" /></td>
  263. </tr>
  264. <tr>
  265. <td height="26" width="457"> If Yes, what date were you charge?</td>
  266. <td height="26" width="479" colspan="2"> Date:
  267. <input type="text" name="Date_Charged" size="15" /></td>
  268. </tr>
  269. <tr>
  270. <td height="23" width="457" bgcolor="#601e05">Are
  271. you currently on probation?</td>
  272. <td height="23" width="125" bgcolor="#601e05">YES
  273. <input type="radio" value="Yes" name="On_Probation" /></td>
  274. <td height="23" width="354" bgcolor="#601e05">NO
  275. <input type="radio" value="No" name="On_Probation" /></td>
  276. </tr>
  277. <tr>
  278. <td height="23" width="457">Are
  279. you currently employed?</td>
  280. <td height="23" width="125">YES
  281. <input type="radio" value="Yes" name="Currently_Employed" /></td>
  282. <td height="23" width="354">NO
  283. <input type="radio" value="No" name="Currently_Employed" /></td>
  284. </tr>
  285. <tr>
  286. <td height="25" width="457" bgcolor="#601e05">If
  287. so, may we contact your employer?</td>
  288. <td height="25" width="125" bgcolor="#601e05">YES
  289. <input type="radio" value="Yes" name="Contact_Current_Employer" /></td>
  290. <td height="25" width="354" bgcolor="#601e05">NO
  291. <input type="radio" value="No" name="Contact_Current_Employer" /></td>
  292. </tr>
  293. </table>
  294. <p><b><br />
  295. Employment History</b></p>
  296. <table border="0" width="606" height="234" cellspacing="0" cellpadding="4">
  297. <tr>
  298. <td height="15" width="233"> Dates</td>
  299. <td height="15" width="191"> From:
  300. <input type="text" name="Start_Date" size="15" /></td>
  301. <td height="15" width="158"> To:
  302. <input type="text" name="End_Date" size="15" /></td>
  303. </tr>
  304. <tr>
  305. <td height="15" width="233" bgcolor="#601e05"> NAME OF COMPANY:</td>
  306. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Name" size="45" /></td>
  307. </tr>
  308. <tr>
  309. <td height="15" width="233"> ADDRESS:</td>
  310. <td height="15" width="357" colspan="2"><input type="text" name="Company_Address" size="45" /></td>
  311. </tr>
  312. <tr>
  313. <td height="15" width="233" bgcolor="#601e05"> PHONE:</td>
  314. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Phone" size="45" /></td>
  315. </tr>
  316. <tr>
  317. <td height="15" width="233"> POSITION:</td>
  318. <td height="15" width="357" colspan="2"><input type="text" name="Position" size="45" /></td>
  319. </tr>
  320. <tr>
  321. <td height="15" width="233" bgcolor="#601e05"> RATE OF PAY:</td>
  322. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Rate_Of_Pay" size="45" /></td>
  323. </tr>
  324. <tr>
  325. <td height="23" width="233"> DUTIES:</td>
  326. <td height="23" width="357" colspan="2"><input type="text" name="Duties" size="45" /></td>
  327. </tr>
  328. <tr>
  329. <td height="23" width="233" bgcolor="#601e05"> REASON FOR LEAVING:</td>
  330. <td height="23" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Reason_For_Leaving" size="45" /></td>
  331. </tr>
  332. <tr>
  333. <td height="23" width="233"> MAY WE CONTACT THIS EMPLOYER?</td>
  334. <td height="23" width="357" colspan="2"> YES
  335. <input type="radio" value="Yes" name="Contact_Employer" />
  336. &nbsp;&nbsp;
  337. NO
  338. <input type="radio" value="No" name="Contact_Employer" /></td>
  339. </tr>
  340. </table><p><b>2</b></p>
  341. <table border="0" width="606" height="234" cellspacing="0" cellpadding="4">
  342. <tr>
  343. <td height="15" width="233"> Dates</td>
  344. <td height="15" width="191"> From:
  345. <input type="text" name="Start_Date0" size="15" /></td>
  346. <td height="15" width="158"> To:
  347. <input type="text" name="End_Date0" size="15" /></td>
  348. </tr>
  349. <tr>
  350. <td height="15" width="233" bgcolor="#601e05"> NAME OF COMPANY:</td>
  351. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Name0" size="45" /></td>
  352. </tr>
  353. <tr>
  354. <td height="15" width="233"> ADDRESS:</td>
  355. <td height="15" width="357" colspan="2"><input type="text" name="Company_Address0" size="45" /></td>
  356. </tr>
  357. <tr>
  358. <td height="15" width="233" bgcolor="#601e05"> PHONE:</td>
  359. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Phone0" size="45" /></td>
  360. </tr>
  361. <tr>
  362. <td height="15" width="233"> POSITION:</td>
  363. <td height="15" width="357" colspan="2"><input type="text" name="Position0" size="45" /></td>
  364. </tr>
  365. <tr>
  366. <td height="15" width="233" bgcolor="#601e05"> RATE OF PAY:</td>
  367. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Rate_Of_Pay0" size="45" /></td>
  368. </tr>
  369. <tr>
  370. <td height="23" width="233"> DUTIES:</td>
  371. <td height="23" width="357" colspan="2"><input type="text" name="Duties0" size="45" /></td>
  372. </tr>
  373. <tr>
  374. <td height="23" width="233" bgcolor="#601e05"> REASON FOR LEAVING:</td>
  375. <td height="23" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Reason_For_Leaving0" size="45" /></td>
  376. </tr>
  377. <tr>
  378. <td height="23" width="233"> MAY WE CONTACT THIS EMPLOYER?</td>
  379. <td height="23" width="357" colspan="2"> YES
  380. <input type="radio" value="Yes" name="Contact_Employer2" />
  381. &nbsp;&nbsp;
  382. NO
  383. <input type="radio" value="No" name="Contact_Employer2" /></td>
  384. </tr>
  385. </table>
  386.  
  387. <p ><b>3</b></p>
  388. <table border="0" width="606" height="234" cellspacing="0" cellpadding="4">
  389. <tr>
  390. <td height="15" width="233"> Dates</td>
  391. <td height="15" width="191"> From:
  392. <input type="text" name="Start_Date1" size="15" /></td>
  393. <td height="15" width="158"> To:
  394. <input type="text" name="End_Date1" size="15" /></td>
  395. </tr>
  396. <tr>
  397. <td height="15" width="233" bgcolor="#601e05"> NAME OF COMPANY:</td>
  398. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Name1" size="45" /></td>
  399. </tr>
  400. <tr>
  401. <td height="15" width="233"> ADDRESS:</td>
  402. <td height="15" width="357" colspan="2"><input type="text" name="Company_Address1" size="45" /></td>
  403. </tr>
  404. <tr>
  405. <td height="15" width="233" bgcolor="#601e05"> PHONE:</td>
  406. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Phone1" size="45" /></td>
  407. </tr>
  408. <tr>
  409. <td height="15" width="233"> POSITION:</td>
  410. <td height="15" width="357" colspan="2"><input type="text" name="Position1" size="45" /></td>
  411. </tr>
  412. <tr>
  413. <td height="15" width="233" bgcolor="#601e05"> RATE OF PAY:</td>
  414. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Rate_Of_Pay1" size="45" /></td>
  415. </tr>
  416. <tr>
  417. <td height="23" width="233"> DUTIES:</td>
  418. <td height="23" width="357" colspan="2"><input type="text" name="Duties1" size="45" /></td>
  419. </tr>
  420. <tr>
  421. <td height="23" width="233" bgcolor="#601e05"> REASON FOR LEAVING:</td>
  422. <td height="23" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Reason_For_Leaving1" size="45" /></td>
  423. </tr>
  424. <tr>
  425. <td height="23" width="233"> MAY WE CONTACT THIS EMPLOYER?</td>
  426. <td height="23" width="357" colspan="2"> YES
  427. <input type="radio" value="Yes" name="Contact_Employer3" />
  428. &nbsp;&nbsp;
  429. NO
  430. <input type="radio" value="No" name="Contact_Employer3" /></td>
  431. </tr>
  432. </table>
  433.  
  434. <p><b>Highschool</b></p>
  435. <table border="0" width="723" height="177" cellspacing="0" cellpadding="4">
  436. <tr>
  437. <td height="30" width="227" bgcolor="#601e05"> DATES:</td>
  438. <td height="30" width="191" bgcolor="#601e05">From:
  439. <input type="text" name="Highschool_From" size="15" /></td>
  440. <td height="30" width="281" bgcolor="#601e05">To:
  441. <input type="text" name="Highschool_To" size="15" /></td>
  442. </tr>
  443. <tr>
  444. <td height="30" width="227">NAME
  445. OF SCHOOL</td>
  446. <td height="30" width="480" colspan="2"><input type="text" name="Highschool_Name" size="44" /></td>
  447. </tr>
  448. <tr>
  449. <td height="30" width="227" bgcolor="#601e05">ADDRESS:</td>
  450. <td height="30" width="480" colspan="2" bgcolor="#601e05"><input type="text" name="Highschool_Address" size="44" /></td>
  451. </tr>
  452. <tr>
  453. <td height="28" width="227">DID YOU GRADUATE:</td>
  454. <td height="28" width="480" colspan="2">YES
  455. <input type="radio" value="Yes" name="Graduate_Highschool" />
  456. &nbsp;&nbsp; NO
  457. <input type="radio" value="No" checked name="Graduate_Highschool" /></td>
  458. </tr>
  459. <tr>
  460. <td height="30" width="227" bgcolor="#601e05">If yes what year?</td>
  461. <td height="30" width="480" colspan="2" bgcolor="#601e05"><input type="text" name="Year_Graduated_Highschool" size="44" /></td>
  462. </tr>
  463. <tr>
  464. <td height="28" width="227">If no, did you receive
  465. a GED?</td>
  466. <td height="28" width="480" colspan="2">YES
  467. <input type="radio" value="Yes" name="GED" />
  468. &nbsp;&nbsp; NO
  469. <input type="radio" value="No" name="GED" /></td>
  470. </tr>
  471. </table>
  472. <p><b>COLLEGE</b></p>
  473. <table border="0" width="723" height="177" cellspacing="0" cellpadding="4">
  474. <tr>
  475. <td height="30" width="227" bgcolor="#601e05">DATES:</td>
  476. <td height="30" width="191" bgcolor="#601e05">From:
  477. <input type="text" name="College_From" size="15" /></td>
  478. <td height="30" width="281" bgcolor="#601e05">To:
  479. <input type="text" name="College_To" size="15" /></td>
  480. </tr>
  481. <tr>
  482. <td height="30" width="227">NAME OF SCHOOL</td>
  483. <td height="30" width="480" colspan="2"><input type="text" name="Name_Of_College" size="44" /></td>
  484. </tr>
  485. <tr>
  486. <td height="30" width="227" bgcolor="#601e05">ADDRESS:</td>
  487. <td height="30" width="480" colspan="2" bgcolor="#601e05"><input type="text" name="College_Address" size="44" /></td>
  488. </tr>
  489. <tr>
  490. <td height="28" width="227">DID YOU GRADUATE:</td>
  491. <td height="28" width="480" colspan="2">YES
  492. <input type="radio" value="Yes" name="Graduate_College" />
  493. &nbsp;&nbsp; NO
  494. <input type="radio" value="No" name="Graduate_College" /></td>
  495. </tr>
  496. <tr>
  497. <td height="28" width="227" bgcolor="#601e05">If no, how many hours
  498. have you completed?</td>
  499. <td height="28" width="480" colspan="2" bgcolor="#601e05"><input type="text" name="Hours_Completed" size="44" /></td>
  500. </tr>
  501. </table>
  502. <p><b>SKILLS ABILITIES</b><br />
  503. PLEASE LIST ANY SPECIAL SKILLS, ABILITIES, AND/OR EQUIPMENT YOU CAN OPERATE THAT
  504. MIGHT BE APPLICABLE TO THE POSITION YOU ARE APPLYING FOR.</p>
  505. <table border="0" width="723" height="54" cellspacing="0" cellpadding="4">
  506. <tr>
  507. <td height="23" width="133" align="center"><b>SKILLS</b></td>
  508. <td height="23" width="574"><br />
  509. <textarea rows="5" name="Skills" cols="57"></textarea>
  510. <br />
  511. &nbsp;</td>
  512. </tr>
  513. <tr>
  514. <td height="23" width="133" align="center"><b>EQUIPMENT</b></td>
  515. <td height="23" width="574"><br />
  516. <textarea rows="5" name="Equipment" cols="57"></textarea>
  517. <br />
  518. &nbsp;</td>
  519. </tr>
  520. </table>
  521. <p>
  522. <label>
  523. <input type="checkbox" name="agreement" id="agreement" />
  524. </label>
  525. I certify that all the information submitted by me on
  526. this application is true and complete, and I understand that if any information,
  527. omissions, or misrepresentations are discovered my application may be rejected; and if I am
  528. employed my employment may be immediately terminated In consideration of discovered, and, employed, terminated. my employment, I agree to conform to the
  529. company's rules and regulations and agree that the terms and conditions of my
  530. employment may be changed with or without cause and with or without notice at
  531. any time by M&amp;D Foundation Drilling Industries, Inc. I hereby give M&amp;D
  532. Foundation Drilling Industries permission to obtain copies of my Motor Vehicle Records from any state where I am or have been
  533. a licensed driver, and to receive any information from my previous employers which may be pertinent to my employment.</p>
  534. <br />
  535. <p><script type="text/javascript"
  536. src="http://www.google.com/recaptcha/api/challenge?k=6Lf57vMSAAAAAGg348SlYljZXIVryay2elznQzm_">
  537. </script>
  538. <noscript>
  539. <iframe src="http://www.google.com/recaptcha/api/noscript?k=6Lf57vMSAAAAAGg348SlYljZXIVryay2elznQzm_"
  540. height="300" width="500" frameborder="0"></iframe><br>
  541. <textarea name="recaptcha_challenge_field" rows="3" cols="40">
  542. </textarea>
  543. <input type="hidden" name="recaptcha_response_field"
  544. value="manual_challenge">
  545. </noscript></p>
  546. <p>
  547. <input name="Submit " type="submit" value="Submit" />
  548. <input type="hidden" name="hdwemail" id="hdwemail" value="[email protected]" />
  549. <input type="hidden" name="hdwok" id="hdwok" value="../thank.html" />
  550. <input type="hidden" name="hdwnook" id="hdwnook" value="../error.html" />
  551. <INPUT type="hidden" name="recaptcha-verify" value="http://www.google.com/recaptcha/api/verify"
  552. </p>
  553. <p>&nbsp;</p>
  554. </form>
  555. <div style="clear:both;"></div>
  556. </div>
  557. <div id="call_us">
  558. <img src="images/call_us.png" width="614" height="58" />
  559. </div>
  560. <div style="clear:both;"></div>
  561. </div>
  562. <div id="footer">Copyright 2010 M&D Foundation Drilling Industries, Inc. All Rights Reserved.<br /><br />
  563. <span class="footer_orange">Site Maintained By <a href="mailto:[email protected]">A. Riquelmy</a></a></span></div>
  564. </div>
  565.  
  566.  
  567. <script type="text/javascript">
  568. <!--
  569. swfobject.registerObject("FlashID");
  570. //-->
  571. </script>
  572. </body>
  573. </html>
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