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Home
Services
Complete Portals
Declines
Fans
Foundations
OJI
Shafts
About
Employment
Contact Us
Menu
Home
Services
Complete Portals
Declines
Fans
Foundations
OJI
Shafts
About
Employment
Contact Us
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EMPLOYMENT
JOIN OUR TEAM
FIRST NAME
MIDDLE NAME
LAST NAME
PHONE NUMBER
ADDRESS
CITY
STATE
ZIP CODE
Email
GENERAL INFORMATION
SSN
ARE YOU EMPLOYED NOW?
NO
YES
INCOME EXPECTED
ARE YOU WILLING AND ABLE TO TRAVEL IF YOUR JOB REQUIRES IT?
NO
YES
WHEN ARE YOU AVAILABLE TO WORK?
What are your current job duties or skills?
What position are you applying for at MILLER?
HOW WERE YOU REFERRED TO MILLER?
DO YOU HAVE CURRENT MSHA TRAINING?
NO
YES
Files
YOU MUST PROVIDE PROOF OF IDENTITY AND EMPLOYMENT ELIGIBILITY UPON HIRE.
Are you a U.S. citizen, lawful permanent resident or otherwise authorized to work in U.S. without restriction?
NO
YES
DO YOU HAVE A VALID DRIVER'S LICENSE?
NO
YES
DRIVERS LICENCE NUMBER
REFERENCES
Give a list of 3 persons not related to you, whom you have known at least 1 year.
1ST REFERENCE
NAME
PHONE NUMBER
PERIOD KNOWN
RELATIONSHIP
2ND REFERENCE
NAME
PHONE NUMBER
PERIOD KNOWN
RELATIONSHIP
3RD REFERENCE
NAME
PHONE NUMBER
PERIOD KNOWN
RELATIONSHIP
EMPLOYMENT
1st Employer
PREVIOUS EMPLOYER
CONTACT NAME
PHONE NUMBER
SALARY
2nd Employer
PREVIOUS EMPLOYER
CONTACT NAME
PHONE NUMBER
SALARY
3rd Employer
PREVIOUS EMPLOYER
CONTACT NAME
PHONE NUMBER
SALARY
ACKNOWLEDGEMENTS
Employment is contingent upon passing a pre-employment drug screening.
I authorize MILLER to verify my suitability for employment and the information provided in this application with any person or organization.
All qualified applicants will receive consideration for employment without regard to sex, race, color, sexual orientation, national origin or ancestry, age, or disability. MILLER is an equal opportunity employer.
I agree that, if hired, I will observe all policies and strict confidentiality all affairs of this company and its members.
I declare that I understand that this is an application for a position only and does not imply any promises of employment on behalf of MILLER and that this application may be kept on file for a period of 1 year for future employment references of this company.
I the undersigned applicant hereby declare that all of the information on this application employment form is accurate and true and I understand that any falsehood or omission on my part may be grounds for future dismissal from the position or withdrawal of an offer of employment.
UPLOAD RESUME
RESUME UPLOAD
Date
By checking this box I acknowledge all of the above form to be true and consent to these terms.
I agree -You must select this to proceed
SUBMIT
