Contractor Application | Rogue Energy Services

Who You Are And What You Do

How we reach you and the work you contract for. Required fields are marked.

We do not ask for a Social Security number or date of birth here. If we move forward, a W-9, contractor agreement and insurance certificate are collected through our secure vendor onboarding, never by email or on this form.

Full name (required)

Business or DBA name (optional)

Phone (required)

Email (optional)

City (required)

State (required)

ZIP (required)

Earliest date you are available (required)

Work you do (required)

Your rate (required)

Two Yes Or No Questions

Are you legally eligible to work in the US? (required)

Yes No

If selected, are you willing to consent to a background check? (required)

Yes No

What You Bring

Experience, certifications, equipment and insurance. Attach a resume or cert cards if you have them handy.

Years in this trade (required)

Do you carry general liability insurance? (required)

Yes No

Certifications You Hold

Tools And Equipment

Do you bring your own tools, truck or equipment? (required)

Yes No

Relevant work, in a few lines (optional)

Drag a resume or cert card here or browse files

Optional. PDF, JPG or PNG, 10 MB max, one file

Read And Sign

Last step. Read the statement, type your name, and send it in.

I certify that my answers are true and complete to the best of my knowledge. I understand this is a request to be considered for independent contract work with Rogue Energy Services, not an application for employment, and that no engagement exists until a written contractor agreement is signed. If selected, I understand a Form W-9 and a certificate of insurance will be requested before any work begins.

Type your full legal name (required) Typing your name here acts as your signature.

I have read the statement above and I agree to it. (required)

Contract With Rogue Energy Services

Who You Are And What You Do

What You Bring

Read And Sign

Application Received