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Phone 2
Email Address
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Select your age range.
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14-15
16-17
18+
Have you ever worked at Pebble Isle Marina or Grey Heron Grill?
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Yes
No
If so, when?
How were you referred to Pebble Isle Marina or Grey Heron Grill?
List any relatives who are currently or formerly employed at Pebble Isle Marina or Grey Heron Grill.
Have you ever been convicted of a felony?
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No
If so, please explain.
Work Availability
Date Available to Start Work
/
Month
/
Day
Year
Date
Desired position
Marina Dockhand
Certified Boat Captain
Maintenance Dept.
Grey Heron Grill Kitchen
Grey Heron Grill Waitstaff
Other
Check all of the following circumstances in which you'd be able to work.
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Holidays (Required)
Part-Time
Overtime
Without Prior Notice
Check all of the days you are available to work.
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please specify any other availability limitations.
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Education
High School
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Graduated / GED
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Day
Year
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From
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Month
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Day
Year
Date
College
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Date
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/
Day
Year
Date
Other
e.g. Trade School, Technical Training and/or Certifications
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Currently Attending
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Graduated / Certification
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References
Reference Name 1
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First Name
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-
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Address
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State / Province
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Reference 1 Occupation
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Years Known
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Reference Name 2
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First Name
Last Name
Phone Number
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-
Area Code
Phone Number
Address
*
Street Address
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City
State / Province
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Reference 2 Occupation
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Years Known
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Employment History
Company 1
Position
Responsibilities
Supervisor
Phone Number
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Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
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Starting Salary
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Are you currently employed here?
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No
Starting Date
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Month
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Day
Year
Date
Ending Date
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Year
Date
Reason for leaving
Company 2
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Responsibilities
Supervisor
Phone Number
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Address
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City
State / Province
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Starting Salary
Ending Salary
Are you currently employed here?
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Starting Date
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-
Day
Year
Date
Ending Date
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Month
-
Day
Year
Date
Reason for leaving
Company 3
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Responsibilities
Supervisor
Phone Number
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Area Code
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Address
Street Address
Street Address Line 2
City
State / Province
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Starting Salary
Ending Salary
Are you currently employed here?
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No
Starting Date
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-
Day
Year
Date
Ending Date
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Month
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Day
Year
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Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
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