Application for Employment
Ave W. Seattle, WA 98119
Main Office 206-282-9979 or 800-544-2580 / Fax 206-283-9121
Please answer all questions COMPLETELY. Write in N/A where not applicable.
Last Name: First Name: Middle Initial:
Permanent Street Address:
City: State: Zip:
Do you have the legal right to work in the U.S.? (Proof of identity and legal right to work in the U.S. will be
required AFTER hire.) Yes No
Are you a former employee of this company? Yes No If yes, list past employment dates:
If so, under what name? From: To:
Do you have any relatives
or friends employed here?
Name of relative or friend employed here:
How did you hear about us? Internet Word of Mouth Company Website Other
POSITION(S) APPLIED FOR You must have a U.S. Coast Guard License or Certificate (MMC) for all positions except
deckhand, wiper and cook.
(Requires at least 500 ton
(1500-3000 HP DDE
(Requires at least 500
Second Mate (Requires at least
500 ton license)
A.B. Seaman (Requires Coast Guard
MMC, OSV, Towing, Fishing are okay)
Deckhand (No MMC Required)
QMED / Oiler (MMC required) Wiper (No MMC Required) Cook (No MMC Required)
What USCG license or certificate do you hold?
USCG License Description:
USCG Certificate (AB, QMED, etc.) Description:
Have you operated any of the below warehouse equipment (Please check all that apply and list others that
apply): Yard & Stay Cargo Gear Forklifts Manual / Electric Pallet Jacks
Please list work experience which may qualify you for this job:
EDUCATION Check here if you received a GED rather than graduating from high school .
School Name / City Did you graduate Major Area of Study
High School Yes No
College Yes No
Vocational Yes No
U.S. MILITARY SERVICE RECORD
Training / Work Experience
Time of Service