Employment Application - Captain and Deckhand

Employment Application Form:
Please answer each question accurately and to the best of your ability.

At the bottom you will have the opportunity to attact any additional documents, such as Merchant Mariner's Document(s), Resume, etc.
Personal Information:
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail
Birth Date*

MonthDayYear
Social Security Number*
Are You a U.S. Citizen?*

YesNo
If no, are you legally authorized to work in the United States:*

YesNoNot Applicable
Have You served in the Armed Forces?*

YesNo
If yes, which Branch:
Type of Discharge:

HonorableOther than Honorable
Employment Desired:
Position Desired:*
Daily Pay Desired*
Date You Can Start*

MonthDayYear
Area of Operations (choose all that apply):

RiverGulf InlandOffshore
Have You Worked Here Before?*

YesNo
If yes, when & what position:
Do you have other relatives presently working for Trinity Tugs, LLC?*

YesNo
If yes, please give name and position:
Current Employment:
Current Employer*
Name of Current Employer or NONE if not Employed
Salary
Position
Phone Number:*

Area CodePhone Number
Start Date*

MonthDayYear
Reason for Leaving?*
May We Contact?*

YesNo
Previous Employment:
Previous Employer 1:*
Name of Previous Employer
Phone Number*

Area CodePhone Number
Position:*
Salary:
Reason for Leaving?*
Start Date*

MonthDayYear
End Date*

MonthDayYear
Previous Employer 2:*
Name of Previous Employer
Phone Number*

Area CodePhone Number
Position*
Salary
Reason for Leaving?*
Start Date*

MonthDayYear
End Date*

MonthDayYear
Qualifications:
Are You familiar with the physical and mental requirements of the position for which you are applying?*

YesNo
Are You willing to participate in a Pre-Employment Physical and Drug Screen?*

YesNo
What accommodations would you need:
Can You swim*

YesNo
Do You suffer from sea/motion sickness?*

YesNo
Do you possess a Driver's License*

YesNo
Do you hold a Merchants Mariner's Document (MMD)?*

YesNo
MMD Number:
MMD Rating:
USCG Licenses held:
Date of Issue
Place of Issue
Has there ever been or is there currently pending any Warnings, Suspensions, or Fines against you or your license or MMD?*

YesNoNot Applicable
If yes, please provide details:
Passport Number:
Do You possess a TWIC Card?*

YesNo
STCW*

YesNo
Do you have the agility, strength and flexibility to: (please answer each statement as accurately as possible)
Climb steep or vertical ladders*

YesNo
Maintain balance on a moving deck.*

YesNo
Pull heavy fire hoses up to 400 feet.*

YesNo
Lift fully charged fire hoses.*

YesNo
Rapidly don an exposure suit.*

YesNo
Step over door sills of 24 in. height.*

YesNo
Open/Close doors that weigh up to 56lbs.*

YesNo
If you have any questions about the essential job functions of the position for which you are applying, please contact the personnel manager at BeauT@trinitytugs.com
References:
Reference 1*
Name of Reference
Relationship*
Years Acquainted*
Phone*
Email
Reference 2*
Name of Reference
Relationship*
Years Acquainted*
Phone*
Email
Reference 3
Name of Reference
Relationship
Years Acquainted
Phone
Email
Criminal Background and DOT Drug/Alcohol Violations
Have you ever been convicted of or plead guilty to a felony?*

YesNo
Date:

MonthDayYear
Date
Location and Sentence:
Have you ever been convicted of or plead guilty to any crime?*

YesNo
Date

MonthDayYear
Date
Location and Sentence:
Have you ever been convicted of or plead guilty to any crime involving violence or dishonesty, including forgery, theft, battery, or assault?*

YesNo
Date

MonthDayYear
Date
Location and Sentence
Have you ever tested positive, or refused to test, on any pre-employment, reasonable cause, random, follow-up or post accident or alcohol test?*

YesNo
Are you currently on probations or parole?*

YesNo
If yes, are there any restrictions which would prohibit you from Interstate or Foreign travel?
Has your driver's license ever been suspended?*

YesNo
If yes, which state, date or suspension and length, and current status:
Cover Letter & Resume (Optional):
Cover Letter

Upload a File

Cancelof
Resume

Upload a File

Cancelof
Merchant Mariner's Documents

Browse Files

Cancelof
Please Upload Additional Document Here

Browse Files

Cancelof
Send Application:
By clicking the submit button below and signing, I certify that all of the information provided by me on this application is true and complete. I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected. If I am employed, my employement may be terminated at any time. I agree to conform to the company's rules and regulations, and I agree that my employment and compenstation can be terminated, with or without cause and notice, at any time. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and notice, at any time by the company.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Employment Application Form:

Personal Information:

Employment Desired:

Current Employment:

Previous Employment:

Qualifications:

Do you have the agility, strength and flexibility to: (please answer each statement as accurately as possible)

References:

Criminal Background and DOT Drug/Alcohol Violations

Cover Letter & Resume (Optional):

Send Application: