Longshore Strategic Solutions Signup Sheet
Your privacy is our top priority. The information you provide in this form is encrypted and securely stored. Rest assured, we will never share your data with anyone, under any circumstances. Your trust is important to us, and we are committed to protecting your privacy at all times. Information entered below will be added to our Contractor Database for use in events for the future.
First Name
*
Last Name
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Social Security Number for Accounting and AT&T UID
*
Drivers License State
*
Drivers License #
*
Date of Birth
*
-
Month
-
Day
Year
Date
Recruiters Name (Who gave you the link)
*
Vehicle Make
*
Vehicle Model & Year
*
License Plate #
*
Truck Size
Please Select
1/2 Ton
3/4 Ton
1 Ton
Other
4x4 Capability?
Yes
No
Vehicle Fuel Type
Deisel
Gas
Does your vehicle have trailer brakes
Yes
No
Positions you have experience in (select all that apply)
*
Administrative
Catering / Kitchen
CDL - (Currently Hold)
CDL - Tanker/HAZMAT (Currently Hold)
Equipment Operator (Fork Lift, Skid-Steer, Lull)
Fueling
Generator Mechanics
Housekeeping
Laundry
Logistics / Safety (Requires OSHA 30)
Maintenance
Parking
Sanitation
Security
Transporation (Requires 3/4 ton truck or larger)
Yard Director
Assistant Yard Director
Work Related Skill and/or Experience
*
List of Equipment
3 Phase Electrical Experience
Yes
No
Can Obtain Government Security Clearance?
Already have (Top Secret)
Already have (Secret)
Eligible
Camper 3-man + occupancy?
Yes
No
List any Licenses and/or Certifications
Comments or additional information
Interested in International Work?
Yes
No
Do you have a valid US Passport
Yes
No
If yes to valid Passport, provide Passport # here
Submit
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