APPLICATION FOR EMPLOYMENT

Department of Human Resources

1 West ferry Circus, Canary Wharf, London, E144HA, United Kingdom Tel: +44-770-003-6982. www.chevron.com

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First Name: Middle Name: Last Name: Contact Tel: Passport No:

Date of Issue: Place of Issue: Expiring Date: Spouse Name: Nationality:

Old Address ___________________________________________________________________________ Present Address _______________________________________________________________________ INDICATE YOUR HOURLY CHOICE State: Zip: Social Security No: Date: Position Applied For: Full Time Only: Part-Time Only: Full or Part-Time: Can you work nights: How many hours can you work weekly: Days Available to work:

If under 18years Please List Age: When Available for work ________________________________________________________________

EDUCATION/ TYPE OF SCHOOL: Your Sex: Date of Birth: Place of Birth: Occupation: High School: College: Bus. Or Tread School: Professional School:

Email Address: Have You Ever Been Convicted of a Crime: If yes, Explain Number of Conviction (S) Nature of Offense (S) Leading to Conviction:

Major & Degree: LOCATION (complete mailing address) How Recently such offense (S) Was/Were Committed, Sentence (S) imposed and type:

DO YOU HAVE A DRIVERS LICENSE? YES ____NO_____ WHAT IS YOUR MEANS OF TRANSPORTATION TO WORK
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DRIVERS LICENSE NO ____________________ State of Issue _______________________________________ Operator ____ Commercial (CDL) ________________________________ Chauffeur Expiration Date ______________________________ Have you had accident during the past three years? __YES __NO How many times? _______Have you had any moving violations during the past three years? __YES __NO Work Experience Please list your work experience for the past five years beginning with your most recent job held? _______________________________________________________________________ If you were self-employed, give firm name. Attach additional sheets if necessary. Name of employer ________________ Address ________________________ Name of last ____________________________________________________________________________ Supervisor ___ _________________________________________________________________________ Employment dates Pay or salary _ ________________________________________________________ City, State, Zip Code _____________________________________________________________________ Phone number _________________________________________________________________________ Your last job title___ ______________________________________________________________________ Reason for leaving (be specific) _ __________________________________________________________ List the jobs you held, duties performed, skills used or learned, advancements or promotions While you worked at this company__ _________________________________________ Name of the company _____________________________________________________________________ INSTRUCTIONS These instructions must be followed exactly, Print out and Fill out application form completely and send scan copies via same e-mail. If questions are not applicable, enter "NA." Do not leave questions blank. Be sure to sign when completed. Chevron does not discriminate on the basis of race, colour, national origin, sex, religion, age or disability in employment or the provision of services. Your Resumes will not be accepted in lieu of applications, note that your resume has been checked and you might be undergoing your induction in our Head office in UK

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND INDICATE YOUR UNDERSTANDING AND ACCEPTANCE BY SIGNING IN THE SPACE PROVIDED.

1 I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to hire or, if hired, termination. 2. I understand that as a condition of employment, I will be required to provide legal proof of authorization and Visa to work in the United Kingdom which I will incur the payment and note that Free Economy air Class and Accommodation will be provided by the Company. 3. I understand that the Company could send all the essential documents and appoint British Immigration to assist you in getting your entry clearance (Tier 2 visa & other traveling documents) from the British High Commission in your Country. 4 I understand that some state agencies will check with our verification Department of Chevron, the British intelligence agency Or other organizations, for any criminal history in accordance with applicable statutes. 5 I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you.

Applicants Signature

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