The Lost Sea Employment Application

Please note: Fields marked with an * are required.

Date:
Name: *
Phone: *
-
Address: *
How long at this address? *

Do you have any relatives working at The Lost Sea? If yes, please list name and position:

Person to be notified in case of emergency: *
Address of person to be notified:
Phone number of person to be notified:

Do you have a valid drivers' license? *
License #:
Expiration Date:
Have you ever been convicted of a felony? *
Have you ever been bonded?
Have you ever been refused a bond?
If yes, please explain:
If yes, what branch?

MILITARY SERVICE RECORD:


Have you ever been in the Armed Forces? *
What were your duties in the service? (Include special training)
Dates of duty:
Type of discharge:

EDUCATIONAL BACKGROUND:


Type of School *
Name of School: *
School Address: *
Date Graduated: *
Major or Course: *

Are you a U.S. Citizen? *
Do you want to work: *
I am available to work from this date: *
To this date: *
Are there any hours or dates you cannot work? *
Do you have any problems working weekends? *

PRIOR WORK HISTORY Please list in order, last or present employer first:
1. Name and Address: *
Dates Worked From/To *
Rate of Pay (start/finish): *
Supervisor's Name and Title: *
Reason For Leaving: *

______


2. Name and Address
2. Dates Worked From/To
2. Rate of Pay (start/finish):
2. Supervisor's Name and Title:
2. Reason For Leaving:

______


3. Name and Address
3. Dates Worked From/To
3. Rate of Pay (start/finish):
3. Supervisor's Name and Title:
3. Reason For Leaving:

______


4. Name and Address
4. Dates Worked From/To
4. Rate of Pay (start/finish):
4. Supervisor's Name and Title:
4. Reason For Leaving:

PERSONAL REFERENCES
Excluding former employers or relatives:


1. Name: *
1. Address: *
1. Phone: *
-
1. Known How Long? *

______


2. Name:
2. Address:
2. Phone:
-
2. Known How Long?

______


3. Name:
3. Address:
3. Phone:
-
3. Known How Long?