Jobs – The Port

Position Appliying for:

Name (Last, First, Middle):

Email:

Address:

City:

State:

ZIP Code:

Home Telephone Number:

Business Telephone Number:

Cellular Telephone Number:

Date you can start work:

Salary Desired:

Do you have a High School Diploma or GED?:
YESNO

Check all that you are willing to work

HOURS:
FULL TIMEPART TIME

DAYSEVENINGS

SWINGGRAVEYARDWEEKENDS

Status:
REGULARTEMPORARY

Are you authorized to work in the U.S. on and unrestricted basis?:
YESNO

Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment.):
YESNO

If yes, explain:

Have you been told the essential functions of the job or have you been viewed a copy of the job description listing the essential functions of the job?:
YESNO

Can you perform these essential functions of the job with or without reasonable accommodation?:
YESNO

First Previous

Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, and military training

School Name:

Degree:

Address/City/State:

School Name:

Degree:

Address/City/State:

School Name:

Degree:

Address/City/State:

SPECIAL SKILLS

List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.):

First Previous

Please list three professional references not related to you, with full name, address, phone number, and relationship. If you don’t have three professional references, then list personal, unrelated references.

Name:

Address/City/State:

Phone:

Relationship:

Name:

Address/City/State:

Phone:

Relationship:

Name:

Address/City/State:

Phone:

Relationship:

First Previous

Start with your present or most recent employment and work back. Use separate sheet if necessary. (INCLUDE PAID AND UNPAID POSITIONS)

Job Title #1:

Start Date (mo/day/yr):

End Date (mo/day/yr):

Company Name:

Supervisor's Name:

Phone Number:

City:

State:

ZIP Code:

Duties:

Reason for Leaving:

Starting Salary:

Ending Salary:

May we contact your present employer? :
YESNON/A

Job Title #2:

Start Date (mo/day/yr):

End Date (mo/day/yr):

Company Name:

Supervisor's Name:

Phone Number:

City:

State:

ZIP Code:

Duties:

Reason for Leaving:

Starting Salary:

Ending Salary:

May we contact your present employer? :
YESNON/A

Job Title #3:

Start Date (mo/day/yr):

End Date (mo/day/yr):

Company Name:

Supervisor's Name:

Phone Number:

City:

State:

ZIP Code:

Duties:

Reason for Leaving:

Starting Salary:

Ending Salary:

May we contact your present employer? :
YESNON/A

First Previous

Standard Application for Employment

Please carefully read and answer all questions. You will not be considered for employment if you fail to completely answer all the questions on this application. You may attach a resume, but all questions must be answered

SPECIAL SKILLS