Fillable Form 98121: ARCTIC FJORD, INC. ARCTIC STORM, An

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Form 98121: ARCTIC FJORD, INC. ARCTIC STORM, An

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  • 28 check-boxes
  • 81 other fields

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File type: PDF

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Revised June 2018
ARCTIC FJORD,
INC.
ARCTIC STORM,
INC.
An Equal Opportunity
Employer
Working Towards A Drug-Free
Workplace
2727 Alaskan Way, Pier 69 Seattle, WA
98121
Telephone (206) 547-6557 Fax (206) 633-0668 Email
recruiter@arcticstorm.com
Our Company is an equal opportunity employer and will consider all applicants for all positions equally without regard to
their race, sex, age, color, creed, religion, national origin, veteran status, marital status, sexual orientation, or any disability
as provided in the Americans with Disabilities Act.
This application will be given every consideration, but receipt does not imply that the applicant will be employed. Each
question should be answered in a complete and accurate manner as no action can be taken on this application until all
questions have been answered.
Date:
Name:
Last
First M.I.
Address: _
Street Apt. # City State Zip
Telephone:
(_
)
Alternate:
(_
)
Cellular:
(_
)
E-mail:
Social
Security
Number:
Position
Preference:
Vessel
Preferance:
Do you have a legal right to be employed in the United States: Yes No
What
languages
do
you
speak
fluently?
Are you 18 years or older? Yes No
Please give the following information regarding
schooling/training/apprenticeships
completed (including specialized Armed
Forces Training).
NAME AND LOCATION
NUMBER OF YEARS
COMPLETED
GRADUATION
DEGREE(S)
High School
Yes No
Trade/Business School
Yes No
College/University
Yes No
List
professional
licenses
you
hold
and/or
specialized
skills:
_
Have you ever served in the military? Yes No
Dates
of
Service:
Discharged
Status:
Revised June 2018
Please begin with your most recent employer and list all jobs held
EMPLOYMENT HISTORY
JOB
TITLE
DEPARTMENT
&
DUTIES
EMPLOYMENT
DATES
(Month &
Year)
REASON
FOR
LEAVING
BEGINNING
SALARY
ENDING
SALARY
1.
Phone:
Supervisor:
If presently employed, may we contact
this employer? Yes No
2.
_
Phone:
Supervisor:
3._
_
Phone:
Supervisor:
4._
Phone:
Supervisor:
_
References: List personal or business references other than prior employers and relatives.
Name Complete Address Occupation Telephone
1._
2._
Do we have your permission to contact previous employers, schools and references listed? Yes No
Have
you
ever
worked
for
Arctic
Storm,
Inc.
or
Arctic
Fjord,
Inc.
before?
Yes
No
If
yes,
when?
_
Reason
for
leaving:
Have you ever received a disciplinary suspension or been discharged from any position(s) within the last 4 years?
Yes
No
If
yes,
explain:
Do you have relatives or friends employed by Arctic Storm, Inc./Arctic Fjord, Inc.?
Yes
No
If
yes,
give
names
and
department:
*Answering yes to this will NOT automatically result in your being denied or guaranteed employment.
I understand Arctic Storm, Inc./Arctic Fjord, Inc. will conduct a criminal history check prior to any final hiring decisions and
will use this information and secure other reports regarding my background. I hereby acknowledge that the information
provided is correct and complete to the best of my knowledge. I understand that any incorrect, incomplete or false
statements or information furnished by me may void this application or subject me to discharge at any time after
employment. I also hereby permit my present and prior employers to divulge to this organization relevant personal
information from my personnel file(s) they possess and I agree to hold them and Arctic Storm, Inc./Arctic Fjord, Inc.
harmless from any claims that might arise as a result of such disclosure.
Signature
of
Applicant
:
Date:
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signature
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Form 98121: ARCTIC FJORD, INC. ARCTIC STORM, An

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Completed 19 February 2021

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