Long Beach Sport Fishing Employment Application
						Last Name, First Initial:
Personal Information
Name (Last, First, MI)
Street address
City, State, Zip
Home phone number			Work phone number
Facsimile number			E-mail address
Social security number			Driver’s license number/state/expiration
			(if job involves any driving)
Employment Desired
Position applied for (Office or vessel name & position)
How did you hear about this position?
Date available for work			Desired hours (full time, part time, etc.)
Education
	Name and Address of School	Course of Study		Total Years of Study	Degree/ Diploma
High School						Today’s Date:
Undergraduate College
Graduate/ Professional
Other (Specify)
List any seminars, classes or other education not listed above which may help qualify you for this position (if you need additional space, please use page 7):

Employment Application
Employment History
List below all present and past employers over the past ten years, starting with your most recent employer. Account for all periods of unemployment. You must complete this section even if attaching a resume. May we contact your current employer? YES NO
1.	Employer (current Yes No)		Start Date	End Date	Essential job functions of final position
	Address				1.
	City, State, Zip		Starting Salary	Ending Salary	2.
	Phone number				3.
	Fax number	Supervisor(s)			4.
	Job position(s)	E-mail address of supervisor
	Reason(s) for leaving
	What value did you add to this company or its customers?
2.	Employer		Start Date	End Date	Essential job functions of final position
	Address				1.
	City, State, Zip		Starting Salary	Ending Salary	2.
	Phone number				3.
	Fax number	Supervisor(s)			4.
	Job position(s)	E-mail address of supervisor
	Reason(s) for leaving
	What value did you add to this company or its customers?

[PLEASE CONTINUE ON NEXT PAGE]

Employment Application
Employment History
3.	Employer		Start Date	End Date	Essential job functions of final position
	Address				1.
	City, State, Zip		Starting Salary	Ending Salary	2.
	Phone number				3.
	Fax number	Supervisor(s)			4.
	Job position(s)	E-mail address of supervisor
	Reason(s) for leaving
	What value did you add to this company or its customers?

Employment Application
Additional Information
List any professional, trade, business or civic activities and offices held. You may exclude membership that would reveal gender, race, religion, national origin, ancestry, age, disability or any other protected status.
List any languages other than English that you can speak, read or write that could be of benefit to the position applied for:
	Fluent	Good	Fair
Speak
Read
Write

Employment Application
Additional Information
Have you ever been employed with this company before?	o Yes	o No
If Yes, when?
Do you have any friends or relatives employed by this company?	o Yes	o No
If Yes, please provide their names and relationship to you:
Are you currently employed?	o Yes	oNo
May we contact your employer?	o Yes	o No
Are you currently on “lay off” status and subject to recall?	o Yes	o No
If you are under 18 years of age, can you provide proof of your eligibility to work?	o Yes	o No
If hired, can you provide proof of U.S. citizenship or proof of your legal right to work in the U.S.?	o Yes	o No