Employment Application

This application form and process is to be followed by those applicants wanting to submit their application form using one of the following methods below. Along with this Application form, please attach an Updated Resume, provide copies of ALL current Safety Certification tickets, copy of Valid Driver’s License (Unrestricted), copy of a Three (3) Year Commercial Driver’s Abstract (would be an asset):

Home Phone:
Cell Phone:
Position Applying For:*
1. Have been interviewed by PWS before?
1. If Yes, Division?
1. When?
2. Have you applied to PWS before?
2. If Yes, Division?
2. When?
3. Have you been employed by PWS before?
3. If Yes, Division?
3. When?

Employment Logistics

Date of birth:
SIN #:*
I am able to work away from home (i.e. camp)?
If No, provide reason:
Were you referred by someone from Pimee Well Servicing LP?
If Yes, who referred you?
Are there any personal limitations that may prevent you from attending your job (health, legal, etc.)?
If Yes, provide reason:
If selected for employment are you willing to submit to a pre-employment and random drug screening test?

Driver's Informaton

Do you have reliable transportation?
Are there any driving conditions that would prevent you from attending your job?
If Yes, explain:
Has your operator's license been suspended in the last 2 years?
If Yes, provide reason :
Do you have a valid Operator's License?
Class of License:
Province Issued:
Can you provide PWS with a 3 Year Commercial Driver's Abstract?
If No, explain:

Previous Employment

1. Employer Name & Location
1. Employer Phone#:
1. Position Held:
1. From:
1. To:
1. Reason for Leaving
2. Employer Name & Location
2. Employer Phone#:
2. Position Held:
2. From:
2. To:
2. Reason for Leaving:
3. Employer Name & Location:
3. Employer Phone#:
3. Position Held:
3. From:
3. To:
3. Reason for Leaving:
4. Employer Name & Location
4. Employer Phone#:
4. Position Held:
4. From:
4. To:
4. Reason for Leaving:
5. Employer Name & Location
5. Employer Phone#:
5. Position Held:
5. From:
5. To:
5. Reason for Leaving:


Highest Level of Education?
Certificate/ Diploma/ Degree Achieved?
Date Completed?

Specific Training / Certificates

H2S Alive
H2S Expiry Date:
First Aid & CPR
First Aid Expiry Date:
PST Date Issued:
Well Service Blowout Prevention (WSBOP)
WSBOP Expiry Date:
Defensive Driving
Defensive Driving Expiry Date:
Confined Space
Confined Space Expiry Date:
CAODC Heavy Duty Training
CAODC Heavy Duty Training Date Issued:
1. Other Certification
1. Expiry Date:
2. Other Certification
2. Expiry Date:
TDG Expiry Date:
WHMIS Date Issued:
Gas Detection
Gas Detection Expiry Date:
Fall Protection for Rig Work
Fall Protection Expiry Date:
Fall Rescue for Rig Work
Fall Rescue Expiry Date:
CAODC Convoy Training
CAODC Convoy Training Date Issued:
CAODC Fatigue Management
CAODC Fatigue Management Date Issued:
3. Other Certification
3. Expiry Date:
4. Other Certification
4. Expiry Date:

Safety Regulations / Disclaimer

  1. I understand that failure to comply with Pimee Safety Regulations and government employment standards are grounds for dismissal. I agree to participate in safety courses offered by Pimee or outside training providers.
  2. I certify that statements made in this application are true and correct. I understand that false statements may result in disqualification from employment, or termination with just cause.
  3. I understand and agree that unless otherwise noted Pimee Well Servicing will contact my previous employers for a past employment reference. I, consent to Pimee Well Servicing Lp to obtain any personal and employment related information as required in connection with this application for employment / and or training.
  4. I agree to undergo pre-employment or random Drug and Alcohol Screening, as required of me, for employment with Pimee Well Servicing LP. Pimee Well Servicing LP has undertaken a Substance Use Prevention Policy and Program which includes education and prevention. As part of the prevention, the Company has implemented Alcohol and Drug testing which cam into effect as of January 1, 2006. Therefore, any position of employment offered by Pimee Well Servicing is conditional on negative test results and the selected candidate for the position must undergo an Alcohol and Drug Screening Test upon selection.
  5. By completing and submitting this application form I hereby consent to Pimee Well Servicing’s collection, use and disclosure of my personal information in the manner and for the purposes as described in the Privacy Policy. I understand that Pimee Well Servicing may disclose the above information to other parties such as clients, employees, insurance providers, benefits plan administrators and financial institutions to carry out the purposes described in the Privacy Policy and I consent to such disclosure.

The following is applicable to certain personnel working in Camp (Cenovus – Foster Creek or Christina Lake)

  1. Some employment is based on specific projects and locations. Therefore, it is my responsibility as an employee to remain in camp during my scheduled shift and rotation, unless specifically advised by my immediate Supervisor or by Management. If I fail to abide and adhere to this policy, this will result in disciplinary action (i.e. Suspension, demotion) or immediate termination of employment.
Digital Signature:
Attach Resume and Tickets:*

To submit multiple files select them all before clicking Open

(hold down Ctrl on your keyboard and click on each file to select multiple files)

Word Verification: