Online Application Form

Personal Information

Name

First Last

Birth Date

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Date Available

Position(s) applying for:

Desired (hourly) Salary

Are you a US citizen?

Yes
No

If no, are you authorized to work in the U.S.?

Yes
No

Have You Worked For Myer Marine Services Before?

Yes
No

Start Date:

End Date:

Have You Been Convicted of A Felony?

Yes
No

Please Explain

Education

Name of High School:

City, State of High School:

Did you graduate?

Yes
No

Year Graduated / GED

Name of College/Tech School:

City, State of Colllege/Tech School:

Did you graduate?

Yes
No

Year Graduated

Degree/Field of Study

Certifications

Please list certifications. Examples include: Welding Certifications, Drafting Certifaicatons, Etc. Please include date.

Employment History

Previous Employer #1

Company Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Supervisor Name

Job Title

Responsibilities

Start Date:

End Date:

Starting Salary:

Ending Salary:

Can we contact?

Yes
No

Previous Employer #2

Company Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Supervisor Name

Job Title

Responsibilities

Start Date:

End Date:

Starting Salary:

Ending Salary:

Can we contact?

Yes
No

Previous Employer #3

Company Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Supervisor Name

Job Title

Responsibilities

Start Date:

End Date:

Starting Salary:

Ending Salary:

Can we contact?

Yes
No

Military Service:

Branch of Service:

Enlistment Date:

Discharge Date:

Rank at Discharge:

Highest Rank:

Specialty Title:

Responsibilities

Discharge Type:

Honorable
Other

Please Explain:

References

Reference #1

Name

First Last

Company:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Relationship

Reference #2

Name

First Last

Company:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Relationship

Reference #3

Name

First Last

Company:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Relationship

Additional Information

Please list any skills or abilities not mentioned above, that you feel are prtinent to the position you are applying for.

Acknowledgement

I certify that my answers are true and correct to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application and/or intereview may result in the termination of my employment. Myer Marine Services is an equal oppurtunity employer It is the policy of Myer Marine Services to provide opportunities to all qualified persons without regard to race, creed, color, religous belief, sex, age, national origin, ancestry, physical or mental handicap, or veterans status.

Online Employment Application

Personal Information

Education

Employment History

Military Service:

References

Additional Information

Acknowledgement