Employee Application

PERSONAL INFORMATION

First Name^*

Middle Initial

Last Name^*

Date of Birth

Gender

Male: Female:

Address 1^*

Address 2

City

State^*

Zip^*

Phone^*

Alternative Phone

Email^*

Referred By

Are you 18 years or older?

yes: no:

Are you a citizen of the United States?^*

yes: no:

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

yes: no:

Have you been convicted of a crime in the past 10 years, excluding misdemeanors & summary offenses?^*

yes: no:

If yes, explain conviction

EMPLOYMENT AVAILABILITY

Position Desired^*

Date You Can Start

Desired Salary

Availability

Full-time

Part-time

Are you employed now?

yes: no:

If so, may we contact employer?

yes: no:

Can you work weekends & holidays?

yes: no:

Do you have your own transportation?

yes: no:

If no transportation, explain

Ever applied to Gulfarium?

yes: no:

For what position?

Applied for position when?

EDUCATION HISTORY

High School Name

High School Location

Years Attended High School

Did You Graduate High School?

yes: no:

High School Subjects Studied

College Name

College Location

Years Attended College

Did You Graduate College?

yes: no:

Trade or Other School Name

Trade or Other School Location

Years Attended Trade or Other School

Trade or Other School Years Attended

FORMER EMPLOYERS

Employer 1 Name

Employer 1 Dates

From

To

Employer 1 Address

Employer 1 Contact Person

Employer 1 Contact Phone Number

Employer 1 Salary

Employer 1 Position

Employer 1 Reason For Leaving

Employer 2 Name

Employer 2 Dates

From

To

Employer 2 Address

Employer 2 Contact Person

Employer 2 Contact Phone Number

Employer 2 Salary

Employer 2 Position

Employer 2 Reason For Leaving

Employer 3 Name

Employer 3 Dates

From

To

Employer 3 Address

Employer 3 Contact Person

Employer 3 Contact Phone Number

Employer 3 Salary

Employer 3 Position

Employer 3 Reason For Leaving

GENERAL INFORMATION

What special training or skills do you have that would help you obtain your desired position?

Special Skills

U.S. Military or Naval Service

Rank

REFERENCES

Reference 1 Name

Reference 1 Address

Reference 1 Phone

Reference 1 Occupation

Reference 1 Number Of Years Known

Reference 2 Name

Reference 2 Address

Reference 2 Phone

Reference 2 Occupation

Reference 2 Number Of Years Known

State names of relatives and friends working for us:

OTHER INFORMATION

Resume

Acceptable File Type(s): .doc, .pdf, .jpg

Max Upload Size: 32MB

Memberships in Professional or Civil Organizations

(Exclude those which may disclose your race, religion or national origin)

Organizations

First Aid/Lifesaving

First aid/CPR

Lifeguard Certification Pool

Lifeguard Certification Waterfront

SCUBA Certification