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Application For Employment

Your Email*

Full Name*

Address*

City*

State*

Zip*

Home Phone

Cell Phone

Are you 18 years of age or older?
YesNo

Are there any restriction to the drivers license?
YesNo

If so, explain

Has your license ever been revoked?
YesNo

If so, for what reason?

Have you ever been convicted of a DWI?
YesNo

If so, when and where?

US Coast Guard Maritime Documents - List in Detail

Have you ever had any Coast Guard license or document suspended and/or revoked?
YesNo

Explain:

Have you ever been convicted of a felony?
YesNo

If so, explain:

Where were you prosecuted?

Military Experience

Branch:

Rank:

Reserves:

Present membership in National Guard or Reserves?
YesNo

Type of Discharge?
HonorableDishonorable

Do you have other relatives presently working for SEA SUPPORT VENTURES, LLC?
YesNo

Employment Desired

Position

Date Available

Salary Desired

Are you employed now?
YesNo

If so, may we inquire of your present employer:
YesNo

Have you ever worked for this company before?
YesNo

If so, where and when?

Education

Grammar/High School

Address

From

Did you graduate?
YesNo

Subjects Studied

Trade/Business School or College

Address

From

Did you graduate?
YesNo

Subjects Studied

Former Employers

Please list last three starting with last one first.

Company 1

Address

Phone

Contact

Position

Salary

Reason for Leaving

Type of Work

Company 2

Address

Phone

Contact

Position

Salary

Reason for Leaving

Type of Work

Company 3

Address

Phone

Contact

Position

Salary

Reason for Leaving

Type of Work

Vessel Applicants Only

Type of Wheelhouse License:

Date of first issue:

Exipration date of present license:

Horsepower of vessels operated:

Size of Tow:

Geographical areas worked:

Tankermans Endorsement?
YesNo

Grade of Endoresement:

Tankering Experience

Split Cargo
YesNo

Chemicals
YesNo

Bunkering
YesNo

Hot Oil
YesNo

Closed Gauging
YesNo

Vapor Recovery
YesNo

Applicant's Statement

I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at anytime without prior notice.

Yes, I agree with the above statements.

Need Sea Support?

104 ABC Lane, Cut Off, LA, 70345

(985) 632-6000