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krymson
May 22nd, 2014
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  1. <!----- http://mddrilling.com/employment_application.php -------->
  2.  
  3. <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
  4. <html xmlns="http://www.w3.org/1999/xhtml">
  5. <head>
  6. <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
  7. <title>M&amp;D Foundation Drilling Industries, Inc.</title>
  8. <link href="css/template.css" rel="stylesheet" type="text/css" />
  9. <script src="Scripts/swfobject_modified.js" type="text/javascript"></script>
  10. <script>
  11. var timeout = 500;
  12. var closetimer = 0;
  13. var ddmenuitem = 0;
  14.  
  15. // open hidden layer
  16. function mopen(id)
  17. {
  18. // cancel close timer
  19. mcancelclosetime();
  20.  
  21. // close old layer
  22. if(ddmenuitem) ddmenuitem.style.visibility = 'hidden';
  23.  
  24. // get new layer and show it
  25. ddmenuitem = document.getElementById(id);
  26. ddmenuitem.style.visibility = 'visible';
  27.  
  28. }
  29. // close showed layer
  30. function mclose()
  31. {
  32. if(ddmenuitem) ddmenuitem.style.visibility = 'hidden';
  33. }
  34.  
  35. // go close timer
  36. function mclosetime()
  37. {
  38. closetimer = window.setTimeout(mclose, timeout);
  39. }
  40.  
  41. // cancel close timer
  42. function mcancelclosetime()
  43. {
  44. if(closetimer)
  45. {
  46. window.clearTimeout(closetimer);
  47. closetimer = null;
  48. }
  49. }
  50.  
  51. // close layer when click-out
  52. document.onclick = mclose;
  53. </script>
  54. <style type="text/css">
  55. <!--
  56. body {
  57. background-color: #000;
  58. }
  59. -->
  60. </style>
  61. <script language='JavaScript' type='text/javascript' src='JScript/formValidator.js'></script>
  62. <script>
  63. function validate(formNode){
  64. var formValidatorInstance = new FormValidator(formNode);
  65. formValidatorInstance.addRule('First_Name','First Name Required','required');
  66.  
  67. formValidatorInstance.addRule('Last_Name','Last Name Required','required');
  68.  
  69. formValidatorInstance.addRule('Home_Phone','Home Phone Required','required');
  70.  
  71. formValidatorInstance.addRule('agreement','You must certify that all the information submitted is true.','ischecked');
  72. return formValidatorInstance.validate();
  73. }
  74. </script>
  75. </head>
  76.  
  77. <body>
  78.  
  79.  
  80. <div id="container">
  81. <div id="header">
  82.  
  83. <object id="FlashID" classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" width="1024" height="428">
  84. <param name="movie" value="flash/intro_video.swf" />
  85. <param name="quality" value="high" />
  86. <param name="wmode" value="opaque" />
  87. <param name="swfversion" value="6.0.65.0" />
  88. <!-- 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. -->
  89. <param name="expressinstall" value="Scripts/expressInstall.swf" />
  90. <!-- Next object tag is for non-IE browsers. So hide it from IE using IECC. -->
  91. <!--[if !IE]>-->
  92. <object type="application/x-shockwave-flash" data="flash/intro_video.swf" width="1024" height="428">
  93. <!--<![endif]-->
  94. <param name="quality" value="high" />
  95. <param name="wmode" value="opaque" />
  96. <param name="swfversion" value="6.0.65.0" />
  97. <param name="expressinstall" value="Scripts/expressInstall.swf" />
  98. <!-- The browser displays the following alternative content for users with Flash Player 6.0 and older. -->
  99. <div>
  100. <h4>Content on this page requires a newer version of Adobe Flash Player.</h4>
  101. <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>
  102. </div>
  103. <!--[if !IE]>-->
  104. </object>
  105. <!--<![endif]-->
  106. </object>
  107. </div>
  108. <div id="navbar">
  109. <ul id="sddm">
  110. <li><a href="index.html">Home</a></li>
  111. <li><a href="about_us.html">About Us</a></li>
  112. <li><a href=""
  113. onmouseover="mopen('m2')"
  114. onmouseout="mclosetime()">Services</a>
  115. <div id="m2"
  116. onmouseover="mcancelclosetime()"
  117. onmouseout="mclosetime()">
  118. <a href="open_hole_drilling.html">Open Hole Drilling</a>
  119. <a href="cased_drilling.html">Cased Drilling</a>
  120. <a href="rock_drilling.html">Rock Drilling</a>
  121. <a href="slurry_displaced_drilling.html">Slurry Displaced Drilling</a>
  122. <a href="specialty_drilling.html">Specialty Drilling</a>
  123. <a href="other_services.html">Other Services</a>
  124. </div>
  125. </li>
  126. <li><a href="equipment.html">Equipment</a></li>
  127. <li><a href="photo_gallery.html"> Photo Gallery</a></li>
  128. <li><a href="employment.html"> Employment</a></li>
  129. <li style=" border:none;"><a href="contact_us.html"> Contact Us</a></li>
  130. </ul>
  131. <div style="clear:both"></div>
  132. </div>
  133. <div id="content_container">
  134. <div id="content">
  135. <form action="verify.php" method="post" onsubmit="return validate(this)" accept-charset="iso-8859-1">
  136. <table border="0" width="958" height="79" cellspacing="0" cellpadding="4">
  137. <tr>
  138. <td height="23" width="932" bgcolor="#601e05" colspan="4"><input type="text" name="date" size="20" />
  139. &nbsp; Date:</td>
  140. </tr>
  141. <tr>
  142. <td height="23" width="187"><input type="text" name="First_Name" size="20" />
  143. <br />
  144. First</td>
  145. <td height="23" width="195"><input type="text" name="Middle_Name" size="20" />
  146. <br />
  147. Middle</td>
  148. <td height="23" width="188"><input type="text" name="Last_Name" size="20" />
  149. <br />
  150. Last</td>
  151. <td height="23" width="358">&nbsp;</td>
  152. </tr>
  153. <tr>
  154. <td height="23" width="387" colspan="2" bgcolor="#601e05"><input type="text" name="Home_Address" size="48" />
  155. <br />
  156. Home Address</td>
  157. <td height="23" width="188" bgcolor="#601e05"><input type="text" name="City" size="20" />
  158. <br />
  159. City</td>
  160. <td height="23" width="358" bgcolor="#601e05"><input type="text" name="Zip" size="20" />
  161. <br />
  162. Zip</td>
  163. </tr>
  164. </table>
  165. <table border="0" width="958" height="54" cellspacing="0" cellpadding="4">
  166. <tr>
  167. <td height="23" width="278"><input type="text" name="Home_Phone" size="20" />
  168. <br />
  169. Home Phone</td>
  170. <td height="23" width="299"><input type="text" name="Social_Security" size="20" />
  171. <br />
  172. Social Security</td>
  173. <td height="23" width="354"><input type="text" name="DL_Number" size="20" />
  174. <br />
  175. Drivers License Number</td>
  176. </tr>
  177. <tr>
  178. <td height="23" width="278" bgcolor="#601e05"><input type="text" name="Cell_Phone" size="20" />
  179. <br />
  180. Cell Phone</td>
  181. <td height="23" width="299" bgcolor="#601e05"><input type="text" name="DOB" size="20" />
  182. <br />
  183. Date Of Birth</td>
  184. <td height="23" width="354" bgcolor="#601e05"><input type="text" name="State_Issue_Class" size="20" />
  185. <br />
  186. State Of Issue/Class</td>
  187. </tr>
  188. </table>
  189. <table border="0" width="958" height="54" cellspacing="0" cellpadding="4">
  190. <tr>
  191. <td height="23" width="278"><input type="text" name="Position_Desired" size="20" />
  192. <br />
  193. Position Desired</td>
  194. <td height="23" width="302"><input type="text" name="Salary_Desired" size="20" />
  195. <br />
  196. Salary Desired</td>
  197. <td height="23" width="354"><input type="text" name="Start_Date" size="20" />
  198. <br />
  199. Date You Can Start?</td>
  200. </tr>
  201. <tr>
  202. <td height="23" width="278" bgcolor="#601e05"><input type="text" name="How_Did_You_Hear_About_Us" size="20" />
  203. <br />
  204. How Did you Hear of Us?</td>
  205. <td height="23" width="302" bgcolor="#601e05"><input type="text" name="Previous_Compensation" size="20" />
  206. <br />
  207. Compensation of Last Job?</td>
  208. <td height="23" width="354" bgcolor="#601e05">&nbsp;</td>
  209. </tr>
  210. </table>
  211. <table border="0" width="958" height="333" cellspacing="0" cellpadding="4">
  212. <tr>
  213. <td height="25" width="457">Are
  214. you 18 years of age or older?</td>
  215. <td height="25" width="125">YES
  216. <input type="radio" value="Yes" name="Are_you_18" /></td>
  217. <td height="25" width="354">NO
  218. <input type="radio" value="No" name="Are_you_18" /></td>
  219. </tr>
  220. <tr>
  221. <td height="16" width="457" bgcolor="#601e05">Have
  222. you ever had an &quot;At Fault&quot; accident while on the job? </td>
  223. <td height="16" width="125" bgcolor="#601e05">YES
  224. <input type="radio" value="Yes" name="At_Fault_Accident" /></td>
  225. <td height="16" width="354" bgcolor="#601e05">NO
  226. <input type="radio" value="No" checked name="At_Fault_Accident" /></td>
  227. </tr>
  228. <tr>
  229. <td height="23" width="457">If
  230. yes, explain:</td>
  231. <td height="23" width="479" colspan="2"><input type="text" name="Explain_Accident" size="43" /></td>
  232. </tr>
  233. <tr>
  234. <td height="23" width="457" bgcolor="#601e05"> Number of speeding tickets in the last 3 years?</td>
  235. <td height="23" width="479" colspan="2" bgcolor="#601e05"><input type="text" name="Number_Of_Speeding_Tickets" size="43" /></td>
  236. </tr>
  237. <tr>
  238. <td height="25" width="457">Have
  239. you ever been injured on the job?</td>
  240. <td height="25" width="125">YES
  241. <input type="radio" value="Yes" name="Injured_on_job" /></td>
  242. <td height="25" width="354">NO
  243. <input type="radio" value="No" checked name="Injured_on_job" /></td>
  244. </tr>
  245. <tr>
  246. <td height="23" width="457" bgcolor="#601e05">What
  247. was the outcome of your injuries?</td>
  248. <td height="23" width="479" colspan="2" bgcolor="#601e05"><input type="text" name="Outcome_Of_injuries" size="43" /></td>
  249. </tr>
  250. <tr>
  251. <td height="40" width="457">Are
  252. you prevented from becoming lawfully employed due to immigration status?</td>
  253. <td height="40" width="125">YES
  254. <input type="radio" value="Yes" name="prevented_to_work_lawfully" /></td>
  255. <td height="40" width="354">NO
  256. <input type="radio" value="No" name="prevented_to_work_lawfully" /></td>
  257. </tr>
  258. <tr>
  259. <td height="23" width="457" bgcolor="#601e05">Have
  260. you ever been convicted of a felony?</td>
  261. <td height="23" width="125" bgcolor="#601e05">YES
  262. <input type="radio" value="Yes" name="Convicted_of_Felony" /></td>
  263. <td height="23" width="354" bgcolor="#601e05">NO
  264. <input type="radio" value="No" name="Convicted_of_Felony" /></td>
  265. </tr>
  266. <tr>
  267. <td height="26" width="457"> If Yes, what date were you charge?</td>
  268. <td height="26" width="479" colspan="2"> Date:
  269. <input type="text" name="Date_Charged" size="15" /></td>
  270. </tr>
  271. <tr>
  272. <td height="23" width="457" bgcolor="#601e05">Are
  273. you currently on probation?</td>
  274. <td height="23" width="125" bgcolor="#601e05">YES
  275. <input type="radio" value="Yes" name="On_Probation" /></td>
  276. <td height="23" width="354" bgcolor="#601e05">NO
  277. <input type="radio" value="No" name="On_Probation" /></td>
  278. </tr>
  279. <tr>
  280. <td height="23" width="457">Are
  281. you currently employed?</td>
  282. <td height="23" width="125">YES
  283. <input type="radio" value="Yes" name="Currently_Employed" /></td>
  284. <td height="23" width="354">NO
  285. <input type="radio" value="No" name="Currently_Employed" /></td>
  286. </tr>
  287. <tr>
  288. <td height="25" width="457" bgcolor="#601e05">If
  289. so, may we contact your employer?</td>
  290. <td height="25" width="125" bgcolor="#601e05">YES
  291. <input type="radio" value="Yes" name="Contact_Current_Employer" /></td>
  292. <td height="25" width="354" bgcolor="#601e05">NO
  293. <input type="radio" value="No" name="Contact_Current_Employer" /></td>
  294. </tr>
  295. </table>
  296. <p><b><br />
  297. Employment History</b></p>
  298. <table border="0" width="606" height="234" cellspacing="0" cellpadding="4">
  299. <tr>
  300. <td height="15" width="233"> Dates</td>
  301. <td height="15" width="191"> From:
  302. <input type="text" name="Start_Date" size="15" /></td>
  303. <td height="15" width="158"> To:
  304. <input type="text" name="End_Date" size="15" /></td>
  305. </tr>
  306. <tr>
  307. <td height="15" width="233" bgcolor="#601e05"> NAME OF COMPANY:</td>
  308. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Name" size="45" /></td>
  309. </tr>
  310. <tr>
  311. <td height="15" width="233"> ADDRESS:</td>
  312. <td height="15" width="357" colspan="2"><input type="text" name="Company_Address" size="45" /></td>
  313. </tr>
  314. <tr>
  315. <td height="15" width="233" bgcolor="#601e05"> PHONE:</td>
  316. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Phone" size="45" /></td>
  317. </tr>
  318. <tr>
  319. <td height="15" width="233"> POSITION:</td>
  320. <td height="15" width="357" colspan="2"><input type="text" name="Position" size="45" /></td>
  321. </tr>
  322. <tr>
  323. <td height="15" width="233" bgcolor="#601e05"> RATE OF PAY:</td>
  324. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Rate_Of_Pay" size="45" /></td>
  325. </tr>
  326. <tr>
  327. <td height="23" width="233"> DUTIES:</td>
  328. <td height="23" width="357" colspan="2"><input type="text" name="Duties" size="45" /></td>
  329. </tr>
  330. <tr>
  331. <td height="23" width="233" bgcolor="#601e05"> REASON FOR LEAVING:</td>
  332. <td height="23" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Reason_For_Leaving" size="45" /></td>
  333. </tr>
  334. <tr>
  335. <td height="23" width="233"> MAY WE CONTACT THIS EMPLOYER?</td>
  336. <td height="23" width="357" colspan="2"> YES
  337. <input type="radio" value="Yes" name="Contact_Employer" />
  338. &nbsp;&nbsp;
  339. NO
  340. <input type="radio" value="No" name="Contact_Employer" /></td>
  341. </tr>
  342. </table><p><b>2</b></p>
  343. <table border="0" width="606" height="234" cellspacing="0" cellpadding="4">
  344. <tr>
  345. <td height="15" width="233"> Dates</td>
  346. <td height="15" width="191"> From:
  347. <input type="text" name="Start_Date0" size="15" /></td>
  348. <td height="15" width="158"> To:
  349. <input type="text" name="End_Date0" size="15" /></td>
  350. </tr>
  351. <tr>
  352. <td height="15" width="233" bgcolor="#601e05"> NAME OF COMPANY:</td>
  353. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Name0" size="45" /></td>
  354. </tr>
  355. <tr>
  356. <td height="15" width="233"> ADDRESS:</td>
  357. <td height="15" width="357" colspan="2"><input type="text" name="Company_Address0" size="45" /></td>
  358. </tr>
  359. <tr>
  360. <td height="15" width="233" bgcolor="#601e05"> PHONE:</td>
  361. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Phone0" size="45" /></td>
  362. </tr>
  363. <tr>
  364. <td height="15" width="233"> POSITION:</td>
  365. <td height="15" width="357" colspan="2"><input type="text" name="Position0" size="45" /></td>
  366. </tr>
  367. <tr>
  368. <td height="15" width="233" bgcolor="#601e05"> RATE OF PAY:</td>
  369. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Rate_Of_Pay0" size="45" /></td>
  370. </tr>
  371. <tr>
  372. <td height="23" width="233"> DUTIES:</td>
  373. <td height="23" width="357" colspan="2"><input type="text" name="Duties0" size="45" /></td>
  374. </tr>
  375. <tr>
  376. <td height="23" width="233" bgcolor="#601e05"> REASON FOR LEAVING:</td>
  377. <td height="23" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Reason_For_Leaving0" size="45" /></td>
  378. </tr>
  379. <tr>
  380. <td height="23" width="233"> MAY WE CONTACT THIS EMPLOYER?</td>
  381. <td height="23" width="357" colspan="2"> YES
  382. <input type="radio" value="Yes" name="Contact_Employer2" />
  383. &nbsp;&nbsp;
  384. NO
  385. <input type="radio" value="No" name="Contact_Employer2" /></td>
  386. </tr>
  387. </table>
  388.  
  389. <p ><b>3</b></p>
  390. <table border="0" width="606" height="234" cellspacing="0" cellpadding="4">
  391. <tr>
  392. <td height="15" width="233"> Dates</td>
  393. <td height="15" width="191"> From:
  394. <input type="text" name="Start_Date1" size="15" /></td>
  395. <td height="15" width="158"> To:
  396. <input type="text" name="End_Date1" size="15" /></td>
  397. </tr>
  398. <tr>
  399. <td height="15" width="233" bgcolor="#601e05"> NAME OF COMPANY:</td>
  400. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Name1" size="45" /></td>
  401. </tr>
  402. <tr>
  403. <td height="15" width="233"> ADDRESS:</td>
  404. <td height="15" width="357" colspan="2"><input type="text" name="Company_Address1" size="45" /></td>
  405. </tr>
  406. <tr>
  407. <td height="15" width="233" bgcolor="#601e05"> PHONE:</td>
  408. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Company_Phone1" size="45" /></td>
  409. </tr>
  410. <tr>
  411. <td height="15" width="233"> POSITION:</td>
  412. <td height="15" width="357" colspan="2"><input type="text" name="Position1" size="45" /></td>
  413. </tr>
  414. <tr>
  415. <td height="15" width="233" bgcolor="#601e05"> RATE OF PAY:</td>
  416. <td height="15" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Rate_Of_Pay1" size="45" /></td>
  417. </tr>
  418. <tr>
  419. <td height="23" width="233"> DUTIES:</td>
  420. <td height="23" width="357" colspan="2"><input type="text" name="Duties1" size="45" /></td>
  421. </tr>
  422. <tr>
  423. <td height="23" width="233" bgcolor="#601e05"> REASON FOR LEAVING:</td>
  424. <td height="23" width="357" colspan="2" bgcolor="#601e05"><input type="text" name="Reason_For_Leaving1" size="45" /></td>
  425. </tr>
  426. <tr>
  427. <td height="23" width="233"> MAY WE CONTACT THIS EMPLOYER?</td>
  428. <td height="23" width="357" colspan="2"> YES
  429. <input type="radio" value="Yes" name="Contact_Employer3" />
  430. &nbsp;&nbsp;
  431. NO
  432. <input type="radio" value="No" name="Contact_Employer3" /></td>
  433. </tr>
  434. </table>
  435.  
  436. <p><b>Highschool</b></p>
  437. <table border="0" width="723" height="177" cellspacing="0" cellpadding="4">
  438. <tr>
  439. <td height="30" width="227" bgcolor="#601e05"> DATES:</td>
  440. <td height="30" width="191" bgcolor="#601e05">From:
  441. <input type="text" name="Highschool_From" size="15" /></td>
  442. <td height="30" width="281" bgcolor="#601e05">To:
  443. <input type="text" name="Highschool_To" size="15" /></td>
  444. </tr>
  445. <tr>
  446. <td height="30" width="227">NAME
  447. OF SCHOOL</td>
  448. <td height="30" width="480" colspan="2"><input type="text" name="Highschool_Name" size="44" /></td>
  449. </tr>
  450. <tr>
  451. <td height="30" width="227" bgcolor="#601e05">ADDRESS:</td>
  452. <td height="30" width="480" colspan="2" bgcolor="#601e05"><input type="text" name="Highschool_Address" size="44" /></td>
  453. </tr>
  454. <tr>
  455. <td height="28" width="227">DID YOU GRADUATE:</td>
  456. <td height="28" width="480" colspan="2">YES
  457. <input type="radio" value="Yes" name="Graduate_Highschool" />
  458. &nbsp;&nbsp; NO
  459. <input type="radio" value="No" checked name="Graduate_Highschool" /></td>
  460. </tr>
  461. <tr>
  462. <td height="30" width="227" bgcolor="#601e05">If yes what year?</td>
  463. <td height="30" width="480" colspan="2" bgcolor="#601e05"><input type="text" name="Year_Graduated_Highschool" size="44" /></td>
  464. </tr>
  465. <tr>
  466. <td height="28" width="227">If no, did you receive
  467. a GED?</td>
  468. <td height="28" width="480" colspan="2">YES
  469. <input type="radio" value="Yes" name="GED" />
  470. &nbsp;&nbsp; NO
  471. <input type="radio" value="No" name="GED" /></td>
  472. </tr>
  473. </table>
  474. <p><b>COLLEGE</b></p>
  475. <table border="0" width="723" height="177" cellspacing="0" cellpadding="4">
  476. <tr>
  477. <td height="30" width="227" bgcolor="#601e05">DATES:</td>
  478. <td height="30" width="191" bgcolor="#601e05">From:
  479. <input type="text" name="College_From" size="15" /></td>
  480. <td height="30" width="281" bgcolor="#601e05">To:
  481. <input type="text" name="College_To" size="15" /></td>
  482. </tr>
  483. <tr>
  484. <td height="30" width="227">NAME OF SCHOOL</td>
  485. <td height="30" width="480" colspan="2"><input type="text" name="Name_Of_College" size="44" /></td>
  486. </tr>
  487. <tr>
  488. <td height="30" width="227" bgcolor="#601e05">ADDRESS:</td>
  489. <td height="30" width="480" colspan="2" bgcolor="#601e05"><input type="text" name="College_Address" size="44" /></td>
  490. </tr>
  491. <tr>
  492. <td height="28" width="227">DID YOU GRADUATE:</td>
  493. <td height="28" width="480" colspan="2">YES
  494. <input type="radio" value="Yes" name="Graduate_College" />
  495. &nbsp;&nbsp; NO
  496. <input type="radio" value="No" name="Graduate_College" /></td>
  497. </tr>
  498. <tr>
  499. <td height="28" width="227" bgcolor="#601e05">If no, how many hours
  500. have you completed?</td>
  501. <td height="28" width="480" colspan="2" bgcolor="#601e05"><input type="text" name="Hours_Completed" size="44" /></td>
  502. </tr>
  503. </table>
  504. <p><b>SKILLS ABILITIES</b><br />
  505. PLEASE LIST ANY SPECIAL SKILLS, ABILITIES, AND/OR EQUIPMENT YOU CAN OPERATE THAT
  506. MIGHT BE APPLICABLE TO THE POSITION YOU ARE APPLYING FOR.</p>
  507. <table border="0" width="723" height="54" cellspacing="0" cellpadding="4">
  508. <tr>
  509. <td height="23" width="133" align="center"><b>SKILLS</b></td>
  510. <td height="23" width="574"><br />
  511. <textarea rows="5" name="Skills" cols="57"></textarea>
  512. <br />
  513. &nbsp;</td>
  514. </tr>
  515. <tr>
  516. <td height="23" width="133" align="center"><b>EQUIPMENT</b></td>
  517. <td height="23" width="574"><br />
  518. <textarea rows="5" name="Equipment" cols="57"></textarea>
  519. <br />
  520. &nbsp;</td>
  521. </tr>
  522. </table>
  523. <p>
  524. <label>
  525. <input type="checkbox" name="agreement" id="agreement" />
  526. </label>
  527. I certify that all the information submitted by me on
  528. this application is true and complete, and I understand that if any information,
  529. omissions, or misrepresentations are discovered my application may be rejected; and if I am
  530. employed my employment may be immediately terminated In consideration of discovered, and, employed, terminated. my employment, I agree to conform to the
  531. company's rules and regulations and agree that the terms and conditions of my
  532. employment may be changed with or without cause and with or without notice at
  533. any time by M&amp;D Foundation Drilling Industries, Inc. I hereby give M&amp;D
  534. Foundation Drilling Industries permission to obtain copies of my Motor Vehicle Records from any state where I am or have been
  535. a licensed driver, and to receive any information from my previous employers which may be pertinent to my employment.</p>
  536. <br />
  537. <p>
  538. <form method="post" action="verify.php" onsubmit="return validate(this)">
  539. <?php
  540. require_once('recaptchalib.php');
  541. $publickey = "6Lf57vMSAAAAAGg348SlYljZXIVryay2elznQzm_"; // you got this from the signup page
  542. echo recaptcha_get_html($publickey);
  543. ?>
  544. <input type="submit" name="submit" value="submit" />
  545. <input type="hidden" name="hdwemail" id="hdwemail" value="jonathon@katycomputertutors.com" />
  546. </form>
  547. </p>
  548. <p>
  549. <!-- <input name="Submit " type="submit" value="Submit" />
  550.  
  551. <input type="hidden" name="hdwok" id="hdwok" value="../thank.html" />
  552. <input type="hidden" name="hdwnook" id="hdwnook" value="../error.html" />-->
  553. </p>
  554. <p>&nbsp;</p>
  555. </form>
  556. <div style="clear:both;"></div>
  557. </div>
  558. <div id="call_us">
  559. <img src="images/call_us.png" width="614" height="58" />
  560. </div>
  561. <div style="clear:both;"></div>
  562. </div>
  563. <div id="footer">Copyright 2010 M&D Foundation Drilling Industries, Inc. All Rights Reserved.<br /><br />
  564. <span class="footer_orange">Site Maintained By <a href="mailto:angie.riquelmy@gmail.com">A. Riquelmy</a></a></span></div>
  565. </div>
  566.  
  567.  
  568. <script type="text/javascript">
  569. <!--
  570. swfobject.registerObject("FlashID");
  571. //-->
  572. </script>
  573. </body>
  574. </html>
  575.  
  576. <!------------ END of employment_application.php ------------------->
  577.  
  578.  
  579.  
  580.  
  581.  
  582.  
  583.  
  584.  
  585. <!----------- Begin Verify.php -------------------->
  586.  
  587.  
  588. <?php
  589. require_once('recaptchalib.php');
  590. $privatekey = "6Lf57vMSAAAAAGW_qgoTQ6c4SLj0jugnjXGFaPl8";
  591. $resp = recaptcha_check_answer ($privatekey,
  592. $_SERVER["REMOTE_ADDR"],
  593. $_POST["recaptcha_challenge_field"],
  594. $_POST["recaptcha_response_field"]);
  595. if (!$resp->is_valid) {
  596. // What happens when the CAPTCHA was entered incorrectly
  597. die ("The reCAPTCHA wasn't entered correctly. Go back and try it again." .
  598. "(reCAPTCHA said: " . $resp->error . ")");
  599. } else {
  600. // Your code here to handle a successful verification
  601. echo "
  602. <!DOCTYPE html PUBLIC \"-//W3C//DTD XHTML 1.0 Transitional//EN\" \"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd\">
  603. <html>
  604. <head>
  605. <meta http-equiv=\"Content-Type\" content=\"text/html; charset=utf-8\" />
  606. <title>M&amp;D Foundation Drilling Industries, Inc.</title>
  607. <link href=\"css/template.css\" rel=\"stylesheet\" type=\"text/css\" />
  608. <script src=\"Scripts/swfobject_modified.js\" type=\"text/javascript\"></script>
  609. <script>
  610. var timeout = 500;
  611. var closetimer = 0;
  612. var ddmenuitem = 0;
  613.  
  614. // open hidden layer
  615. function mopen(id)
  616. {
  617. // cancel close timer
  618. mcancelclosetime();
  619.  
  620. // close old layer
  621. if(ddmenuitem) ddmenuitem.style.visibility = 'hidden';
  622.  
  623. // get new layer and show it
  624. ddmenuitem = document.getElementById(id);
  625. ddmenuitem.style.visibility = 'visible';
  626.  
  627. }
  628. // close showed layer
  629. function mclose()
  630. {
  631. if(ddmenuitem) ddmenuitem.style.visibility = 'hidden';
  632. }
  633.  
  634. // go close timer
  635. function mclosetime()
  636. {
  637. closetimer = window.setTimeout(mclose, timeout);
  638. }
  639.  
  640. // cancel close timer
  641. function mcancelclosetime()
  642. {
  643. if(closetimer)
  644. {
  645. window.clearTimeout(closetimer);
  646. closetimer = null;
  647. }
  648. }
  649.  
  650. // close layer when click-out
  651. document.onclick = mclose;
  652. </script>
  653. <style type=\"text/css\">
  654. <!--
  655. body {
  656. background-color: #000;
  657. }
  658. -->
  659. </style>
  660. <script language='JavaScript' type='text/javascript' src='JScript/formValidator.js'></script>
  661. <script>
  662. function validate(formNode){
  663. var formValidatorInstance = new FormValidator(formNode);
  664. formValidatorInstance.addRule('First_Name','First Name Required','required');
  665.  
  666. formValidatorInstance.addRule('Last_Name','Last Name Required','required');
  667.  
  668. formValidatorInstance.addRule('Home_Phone','Home Phone Required','required');
  669.  
  670. formValidatorInstance.addRule('agreement','You must certify that all the information submitted is true.','ischecked');
  671. return formValidatorInstance.validate();
  672. }
  673. </script>
  674. </head>
  675.  
  676. <body>
  677.  
  678.  
  679. <div id=\"container\">
  680. <div id=\"header\">
  681.  
  682. <object id=\"FlashID\" classid=\"clsid:D27CDB6E-AE6D-11cf-96B8-444553540000\" width=\"1024\" height=\"428\">
  683. <param name=\"movie\" value=\"flash/intro_video.swf\" />
  684. <param name=\"quality\" value=\"high\" />
  685. <param name=\"wmode\" value=\"opaque\" />
  686. <param name=\"swfversion\" value=\"6.0.65.0\" />
  687. <!-- 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. -->
  688. <param name=\"expressinstall\" value=\"Scripts/expressInstall.swf\" />
  689. <!-- Next object tag is for non-IE browsers. So hide it from IE using IECC. -->
  690. <!--[if !IE]>-->
  691. <object type=\"application/x-shockwave-flash\" data=\"flash/intro_video.swf\" width=\"1024\" height=\"428\">
  692. <!--<![endif]-->
  693. <param name=\"quality\" value=\"high\" />
  694. <param name=\"wmode\" value=\"opaque\" />
  695. <param name=\"swfversion\" value=\"6.0.65.0\" />
  696. <param name=\"expressinstall\" value=\"Scripts/expressInstall.swf\" />
  697. <!-- The browser displays the following alternative content for users with Flash Player 6.0 and older. -->
  698. <div>
  699. <h4>Content on this page requires a newer version of Adobe Flash Player.</h4>
  700. <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>
  701. </div>
  702. <!--[if !IE]>-->
  703. </object>
  704. <!--<![endif]-->
  705. </object>
  706. </div>
  707. <div id=\"navbar\">
  708. <ul id=\"sddm\">
  709. <li><a href=\"index.html\">Home</a></li>
  710. <li><a href=\"about_us.html\">About Us</a></li>
  711. <li><a href=\"\"
  712. onmouseover=\"mopen('m2')\"
  713. onmouseout=\"mclosetime()\">Services</a>
  714. <div id=\"m2\"
  715. onmouseover=\"mcancelclosetime()\"
  716. onmouseout=\"mclosetime()\">
  717. <a href=\"open_hole_drilling.html\">Open Hole Drilling</a>
  718. <a href=\"cased_drilling.html\">Cased Drilling</a>
  719. <a href=\"rock_drilling.html\">Rock Drilling</a>
  720. <a href=\"slurry_displaced_drilling.html\">Slurry Displaced Drilling</a>
  721. <a href=\"specialty_drilling.html\">Specialty Drilling</a>
  722. <a href=\"other_services.html\">Other Services</a>
  723. </div>
  724. </li>
  725. <li><a href=\"equipment.html\">Equipment</a></li>
  726. <li><a href=\"photo_gallery.html\"> Photo Gallery</a></li>
  727. <li><a href=\"employment.html\"> Employment</a></li>
  728. <li style=\" border:none;\"><a href=\"contact_us.html\"> Contact Us</a></li>
  729. </ul>
  730. <div style=\"clear:both\"></div>
  731. </div>
  732. <div id=\"content_container\">
  733. <div id=\"content\">
  734. <h2>Thank You we will review your application and get back with you shortly</h2>
  735. <div style=\"clear:both;\"></div>
  736. </div>
  737. <div id=\"call_us\">
  738. <img src=\"images/call_us.png\" width=\"614\" height=\"58\" />
  739. </div>
  740. <div style=\"clear:both;\"></div>
  741. </div>
  742. <div id=\"footer\">Copyright 2010 M&D Foundation Drilling Industries, Inc. All Rights Reserved.<br /><br />
  743. <span class=\"footer_orange\">Site Maintained By <a href=\"mailto:angie.riquelmy@gmail.com\">A. Riquelmy</a></a></span></div>
  744. </div>
  745.  
  746.  
  747. <script type=\"text/javascript\">
  748. <!--
  749. swfobject.registerObject(\"FlashID\");
  750. //-->
  751. </script>
  752. </body>
  753. </html>
  754.  
  755.  
  756.  
  757.  
  758.  
  759. ";
  760. }
  761. ?>
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