OSL Employment Application Form

Name:*

First Name and Middle NameLast Name
Cell Phone Number:*

Area CodePhone Number
E-mail Address:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date*

MonthDayYear
Do You Have a Driver's License?*
If yes, DL# and State of Issue
Are You a U.S. Citizen?*
If not a U.S. Citizen, do you possess a valid Visa or Alien registration card permitting you to work n the U.S.?
Date Available for Employment?*

MonthDayYear
Date
Position for which you are applying?*
Pull-down for a list of positions
Upload Resume:

Upload Resume

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Upload Marine Credentials:

Upload Credentials
Copies of USCG MM, DPO, other licenses Cancelof
Education, Job Skills & Training
High School *
School Name
Date Graduated H.S.*

MonthDayYear
Date
College or Maritime Academy*
Institution Name, Degree Obtained
Date Degree Obtained

MonthDayYear
Date
Vocational or Maritime Training
Please Describe
Other Training:
Please Describe
Check all in which you are proficient.

MS OutlookMS WordMS ExcelMS Power Point
List any other computer Software packages/programs in which you are proficient.
Qualifications
Highest License Currently Held:*
USCG Chief Engineer, Unlimited Oceans or Master OSV, Unlimited Oceans
License Issue Date:*

MonthDayYear
Date
PIC Tanker Endorsement*
Towing Endorsement*
Years of OSV Experience*
Z-card Expiration Date*

MonthDayYear
Date
Employment History

Start with you most recent employment.
1. Company Name*
Position*
Supervisor*
Phone Number*

Area CodePhone Number
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
Reason for Leaving*
2. Company*
Position*
Supervisor*
Phone Number*

Area CodePhone Number
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
Reason for Leaving*
References

Please list two (2) references that are familiar with your work.
Reference 1
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reference 2
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
I certify that the facts contained in this application form are true and complete to the best of my knowledge. This form will be submitted to OSL Personnel Department. You can contact the OSL Personnel Department at info@oslconcrete.com.*
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