Fillable Employment Application

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Employment Application

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The Employment Application form is 3 pages long and contains:

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  • 0 check-boxes
  • 91 other fields

Country of origin: OTHERS
File type: PDF

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PO Box 10070 • Southport, NC 28461 • 910.457.6909
capefearpilots@eastnc.twcbc.com
Full Name: ________________________________________________________________ Date: _____/_____/_____
Last First M.I
Address: ______________________________________________________________________________________
Street Apt./Unit #
______________________________________________________________________________________
City State Zip Code
E-mail: __________________________________________ Phone: ____________________ SS#____________________
Date Available: _____/_____/_____ Desired Salary: $_____________
Are you a citizen of e United States? p yes p no
If no, are you authorized to work in e United States? p yes p no
Have you ever worked for this company? p yes p no
If yes, when ___________________________
Have you ever been convicted of a felony? p yes p no
If yes, explain _________________________________________________________________________________
High School: __________________________________ Address: ______________________________________________
From: ________ To: ________ Did you graduate? p yes p no
College: ______________________________________ Address: ______________________________________________
From: ________ To: ________ Did you graduate? p yes p no Degree:_____________________
Other: _______________________________________ Address: ______________________________________________
From: ________ To: ________ Did you graduate? p yes p no Degree:_____________________
Employment Application
Dispatch/Boat Crew Position
Education
Company: _______________________________________________________ Phone #: __________________________
Address: ___________________________________________________________________________________________
Job Title: _______________________________ From: ________ To: ________ Supervisor: ______________________
Responsibilities ______________________________________________________________________________________
___________________________________________________________________________________________________
Reason for Leaving ___________________________________________________________________________________
May we contact your previous supervisor as a reference? p yes p no
Company: _______________________________________________________ Phone #: __________________________
Address: ___________________________________________________________________________________________
Job Title: _______________________________ From: ________ To: ________ Supervisor: ______________________
Responsibilities ______________________________________________________________________________________
___________________________________________________________________________________________________
Reason for Leaving ___________________________________________________________________________________
May we contact your previous supervisor as a reference? p yes p no
Company: _______________________________________________________ Phone #: __________________________
Address: ___________________________________________________________________________________________
Job Title: _______________________________ From: ________ To: ________ Supervisor: ______________________
Responsibilities ______________________________________________________________________________________
___________________________________________________________________________________________________
Reason for Leaving ___________________________________________________________________________________
May we contact your previous supervisor as a reference? p yes p no
Previous Employment
Military Service
Branch: ________________________________________ From: ____________ To: ____________
Rank at Discharge: ______________________
Type of Discharge: ______________________
If other than honorable, explain: _________________________________________________________________________
___________________________________________________________________________________________________
Full Name: ____________________________________________________ Relationship: __________________________
Company: _______________________________________________________ Phone # ___________________________
Address: ___________________________________________________________________________________________
___________________________________________________________________________________________
Full Name: ____________________________________________________ Relationship: __________________________
Company: _______________________________________________________ Phone # ___________________________
Address: ___________________________________________________________________________________________
___________________________________________________________________________________________
Full Name: ____________________________________________________ Relationship: __________________________
Company: _______________________________________________________ Phone # ___________________________
Address: ___________________________________________________________________________________________
___________________________________________________________________________________________
References
Please list three professional references.
Disclaimer
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may
result in my release/termination.
Signature: __________________________________________________ Date: ______/______/______
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Employment Application

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Completed 4 November 2021

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