Employment Application
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Qualified applicants will receive consideration for employment without discrimination because of sex, marital status, race, color creed, national origin, age or the presence of a disability.
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Every attempt is made to keep the information submitted secure, but if you would rather download a copy of this application and fax or mail it into the office, please click here.
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Desired Position: Date:
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  PERSONAL INFORMATION
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Your Name:
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Address:         
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Social Security Number:      Phone Number:    Email:
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Are you legally eligible for employment in the U.S.A.?   
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I am seeking a permanent job?          I am seeking temporary work until (date):
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Are you able to perform the essential functions of the position with or without accommodation?   
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If necessary for the job, I am able to provide a valid drivers license?   
      Drivers License Number:    State:
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If necessary for the job, are you over the age?   
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Are you physically able to work 16 hour days and lift 50 pounds?    
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Do you warrant that you are fit for duty and have no physical disabilities, illness or lingering injuries at the present time?   
      If No, please explain:
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I will be able to REPORT TO WORK     days after BEING NOTIFIED that I am hired.
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  EMPLOYMENT HISTROY
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Please list last employment first. Include summer or temporary jobs. Be sure all of your experience or previous employers are listed here or in the summary.
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Company Name: Position:
Company Address: Salary:    
Job Duties: Supervisor:    
Reason for leaving: Start Date:   Finish Date:
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Company Name: Position:
Company Address: Salary:    
Job Duties: Supervisor:    
Reason for leaving: Start Date:   Finish Date:
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Company Name: Position:
Company Address: Salary:    
Job Duties: Supervisor:    
Reason for leaving: Start Date:   Finish Date:
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  QUALIFICATIONS
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Please detail any previous Longlining experience you may have had:
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List any equipment (electrical or mechanical) that you are qualified to operate or repair:
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Professional Licenses, Certifications, or Registrations:
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Additional skills including supervision skills, other languages, or information regarding the career/occupation you wish to bring to the employer's attention:
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  EDUCATION
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School Name/ Location
Years Completed
Field of Study
Degree
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  REFERENCES
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List two personal references who are not relatives or former supervisors.
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Name: Phone:
Address:
Occupation: Years known:
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Name: Phone:
Address:
Occupation: Years known:
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  EMERGENCY CONTACT
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Name: Phone:
Address:
Relationship:
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Information to the Applicant: As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references.
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If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the U.S.A., have a physical examination and/or drug test, sign a conflict of interest agreement and abide by its terms.
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By clicking the submit button you confirm that you understand and agree to the information shown above.
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Equal Employment Opportunity: While many employers are required by Federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no affect on your application for employment.