Port Ship Service, Inc.
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Online Employment Application

    Today's Date


    First Name


    Last Name


    Middle Initial


    Home Phone


    Work Phone


    Cell Phone


    Street Address


    Address Line 2


    City

    State


    Zip Code


    Sex


    E-Mail


    Position Applying For


    If you are under 18, and it is required, can you furnish a work permit?


    If no, please explain


    Have you ever been employed here before?


    If yes, give dates and positions


    Are you legally eligible for employment in this country?


    Date you are availble to start work


    What is your desired salary range?


    Type of employment desired


    Are you able to meet the attendance requirements of the position?


    Have you ever pled "GUILTY" or "NO CONTEST" to, or been convicted of a crime?


    If yes, please provide date(s) and details

    (Answering yes to these questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken in account.)


    Driver's License Number if driving is an essential job function


    State Driver's license was issued in

    Job History

    Start with the most recent and give us the last 3.

    Job 1

    Employer Name

    Address

    Telephone Number

    Position

    Description for Position

    Start Date

    End Date

    Starting Salary

    Starting Rate of Pay

    Ending Salary

    Ending Rate of Pay

    Your Immediate Supervisor and Title

    May We Contact for a Reference

    Reason for Leaving

    Job 2

    Employer Name

    Address

    Telephone Number

    Position

    Description for Position

    Start Date

    End Date

    Starting Salary

    Starting Rate of Pay

    Ending Salary

    Ending Rate of Pay

    Your Immediate Supervisor and Title

    May We Contact for a Reference

    Reason for Leaving

    Job 3

    Employer Name

    Address

    Telephone Number

    Position

    Description for Position

    Start Date

    End Date

    Starting Salary

    Starting Rate of Pay

    Ending Salary

    Ending Rate of Pay

    Your Immediate Supervisor and Title

    May We Contact for a Reference

    Reason for Leaving

    Skills and Qualifications


    Educational Background

    Name and Location

    Years Attended

    Did You Graduate

    Courses Studied

    High School

    College

    Other

    References

    List 3 people that have known you at least a year, are not related to you and whom you have not previously worked for.

    Name and Address

    Telephone Number

    Years Known

    Applicant Statement

    I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.

    I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (I) cancel further consideration of this application, or (II) immediately discharge me from the employer’s services, whenever it is discovered.

    If I am hired, I understand that I am free to resign at any time, with or without cause and/or prior notice, and the employer reserves the same right to terminate my employment at any time, with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

    I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard.

    DO NOT SEND THIS APPLICATION UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

    Port Ship Service, Inc.

    7121 N. Peter Street
    Arabi, Louisiana 70032
    Mailing Address
    P.O. Box 369
    Arabi, Louisiana 70032-0369
    Office: (504) 279-0486 or (504) 271-6391
    Fax: (504) 271-9337
    portship@portshipservice.com

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