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APPLICATION AND WAIVER

1. APPLICATION
2. WAIVER FORM
3. VOLUNTARY AFFIRMATIVE ACTION FORM
4. BACKGROUND REPORT AUTHORIZATION FORM

It is the policy of Settoon Towing L.L.C. to provide equal opportunity in employment and advancement to all persons without regard to race, color, religion, age, gender/sex, national origin, disability or any other protected status under state and federal laws.

This application is secure (https) and will be held confidential for only Settoon HR use.

1. APPLICATION. Please be complete. This information is strictly confidential.

First:*
 Middle*:
 Last:*
Home Phone:

Cell Phone:  
 Social Security Number:

Driver's License Number:

State of issued Driver's License:

  

I hereby authorize a Settoon representative to contact me:* (check all that apply)
Home Cell phone Email
Address Street:
City: State: Zip:
Email contact address:
Nickname if any:
Place of Birth:
Height: Weight:
Position Applying for:
Captain Relief Captain Wheelman Tankerman Deckhand
Can you perform each of the essential functions of this job?
Yes No

If no, please explain:

Education
High School:
Years Attended:
Did you graduate? Yes No

College/University:
Years Attended:
Did you graduate? Yes No

Vocational/Technical:
Years Attended:
Did you graduate? Yes No
License
What License(s) do you currently hold?
Master of Towing Tankerman Z-card Benzene card

Please explain:

References
Please state the name, address & phone numbers of three (3) references who are not related to you.
Reference 1:


Reference 2:


Reference 3:

Work History
Give the name and address of your last three (3) employers in chronological order:
Employer Phone Dates

2. APPLICANT WAIVER FORM
I certify that the information contained in this job applicant’s identification and information sheet is correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or, if hired, dismissal.

I authorize any of the persons or organization referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application and release all such parties from all liability for any damage that may result from furnishing such information to you. I authorize you to request and receive such information.

In consideration for my employment and my being considered for employment by your company, I agree to conform to the rules and regulations of the company and acknowledge that these rules and regulations may be changed, interpreted, withdrawn, or added to by your company at any time, at the company’s sole option and without any prior notice, at any time, at the option of the company or myself.

I understand that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or assure or make some other personnel move, either prior to commencement of employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or made any agreement contrary to the foregoing.

I acknowledge that I have been advised that this application will remain active for no more that 90 days from the date is was made.

ALL APPLICANTS:
The above information is accurate and complete to the best of my knowledge.
Full Name of Applicant*
Date (mm/dd/yyyy)*     

 

3. VOLUNTARY AFFIRMATIVE ACTION FORM
In compliance with government regulations we are required to track the number of our applicants by gender, race/ethnicity, Veteran status and position for which applied. This information will be kept separately from your application and will be used only in accordance with federal and state regulations.

You are not required to provide this information. Your application for employment will be considered in the same manner whether or not you fill out this form.

Gender: Male Female
Race/Ethnic Group
White (Not of Hispanic origin): All persons having origins in any of the original peoples of Europe, North Africa, or Middle East.
Black (Not of Hispanic origin): All persons having origins in any of the black racial groups of Africa.
Hispanic: All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
Asian or Pacific Islander: All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands, and Samoa.
Native American or Alaskan Native: All persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.
Other (please specify)
 
VETERAN STATUS:
Not a Veteran
Veteran Era Veteran

Veteran

 Disabled Veteran

 
Name:
Date of Application:
Position applied for:
Referred by:
How did you learn about the position?