Detyens Shipards Application for Employment with EEO form

Position applied for*

Date of Application*

Date

Name*

First NameMiddle NameLast Name

Social Security*

Street*

City*

State*

Zip Code*

Email Address*

example@example.com

Are you at least 18 years old?*

YesNo

Date you are available for work

Date

Type of employment desired:*

Full-TimePart-TimeTemporary

Will you work any shift?*

YesNo

Will you regularly and consistently work a ten or twelve hour daily schedule?*

YesNo

Will you regularly and consistently work your assigned work schedule?*

YesNo

Will you regularly and consistently be available for overtime?*

YesNo

Will you work Saturdays and/or Sundays if required?*

YesNo

Have you ever been convicted of a felony?

YesNo

If yes, please explain

Employment History Provide the following information of your past employment by starting with your present or last job.

Employer*

From Date*

Date

Date*

Date

Address*

Job Title*

Telephone*

Supervisor*

Reason for Leaving*

Rate of Pay*

Summarize the work performed and job responsibilities*

Employer*

From Date*

Date

To Date*

Date

Address

Job Title

Telephone

Supervisor

Reason for Leaving

Rate of Pay

Summarize the work performed and job responsibilities

Summarize any training skills licensesand or certificates that may qualify you as being able to perform jobrelated functions in the position for which you are applying:*

Check any of the following trades in which you are qualified:*

Did you serve in the U.S. Armed Forces?*

YesNo

If yes, describe any military training received relevant to the position for which you are applying:

Veteran Voluntary Self-Identification - (VETS 4212)

We are a Federal Contractor covered by the VETS-4212 reporting requirements in the Part 61-300 regulations. Under the regulations implementing the affirmative action provisions of VEVRAA issued by the Office of Federal Contract Compliance Programs (OFCCP), we are required to invite applicants to inform whether he or she is a veteran belonging to one or more of the categories of veterans covered under VEVRAA who wishes to benefit under the contractor's affirmative action program (AAP) for covered veterans. In extending this invitation, you are advised that you are under no obligation to respond, but may do SO in the future if you choose. Your response will remain confidential within the human resources department, and will be used only for the necessary information to include in our Veterans 4212 report. Refusal to provide this information will not subject you to any adverse treatment.

Other Protected Veteran: Veteran who served on active duty in the U.S. military during a war or in a campaign or expedition for which a campaign badge is awardedNone / I do not wish to Self-Identify

How did you learn about us?*

Are you capable of performing in a reasonable manner, with or without reasonable accommodation, the activities involved in the job or occupation for which you have applied? A description of the activities involved in such a job or occupation is attached?*

YesNo

Please browse to your file or drag/drop it in the area below to upload your résumé

Skills & Qualifications

Military Experience

Referral Information

NOTE TO APPLICANTS: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

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An Equal Opportunity Employer