Goetz Boats - Custom Built Sailing Boats, Racing Yachts, Power Boats

EMPLOYMENT APPLICATION

Name:		Date Completed:
Street Address:
City/Town:
State:		Zip:
Home Phone:
Other Phone:
Email:

Position Applying For:
Salary Expections:
Have you ever applied for employment with us?	Yes No If Yes, Month and Year:

For purposes of compliance with The Immigration Reform and Control Act, are you legally eligible for employment in the United States? Yes No

(Under the Immigration Reform and Control Act of 1986, you will be required to fill out a certification verifying that you are eligible to be employed and verifying your identify. Further, you will be required to provide documentation to that effect should you be employed.)

Days/hours available to work:

Have you ever been convicted of or charged with a felony or misdemeanor? Yes No

If yes, please explain details in full, including dates, detail of offense(s) charged, jurisdiction of disposition of case:

EDUCATION

Schools/Colleges Attended:	# of Years:	Degree:

EMPLOYMENT

Start with your present or most recent position. Include military service assignments.

Job Title:
Start Date:
End Date:
Employer Name:
Employer Address:
Employer Phone:
Salary:
Supervisor:
Reason for Leaving:
Status:	Full Time Part Time Temporary
Name Hired Under: (if different than on application)

Job Title:
Start Date:
End Date:
Employer Name:
Employer Address:
Employer Phone:
Salary:
Supervisor:
Reason for Leaving:
Status:	Full Time Part Time Temporary
Name Hired Under: (if different than on application)

Job Title:
Start Date:
End Date:
Employer Name:
Employer Address:
Employer Phone:
Salary:
Supervisor:
Reason for Leaving:
Status:	Full Time Part Time Temporary
Name Hired Under: (if different than on application)

Job Title:
Start Date:
End Date:
Employer Name:
Employer Address:
Employer Phone:
Salary:
Supervisor:
Reason for Leaving:
Status:	Full Time Part Time Temporary
Name Hired Under: (if different than on application)

QUESTIONS PERTAINING TO BOAT BUILDER'S JOB

Please check one box for each of the following questions:	YES	NO
An essential function of the boat builder job is that you have good hand-eye coordination. Can you perform this function?
An essential function of the boat builder job is the ability to climb. Can you perform this function?
An essential function of the boat builder job is the ability to kneel and/or stand for extended periods of time. Can you perform this function?
An essential function of the boat builder job is the ability to lift up to 50lbs on a regular basis. Can you perform this function?

REFERENCES

List name, addresses, phone and relationships of three persons not related to you who know your qualifications:

Name:
Address:
Phone:
Relationship:

Name:
Address:
Phone:
Relationship:

Name:
Address:
Phone:
Relationship:

I certify that all information listed above and any attachments are true and complete, and I agree and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part to any employment. I hereby authorize any and all schools, former employers, references, courts and any others who have information about me to provide such information to Goetz Custom Boats and/or any of its representatives, agents or vendors and I release all parties involved from any and all liability for any and all damage that may result from providing such information.

I understand and agree that this company will complete a background investigation including but not limited too criminal-conviction and driving record check as a part of the selection process for employment, and the employment offer will be contingent upon the results of these background investigations. I understand and agree that as a condition of employment I must pass a physical examination, and the employment offer will be contingent upon the results of the physical.

I understand that Goetz Custom Boats is in compliance with Rhode Islands Smoke Free Workplace Act and that smoking is not allowed in any building, walkway or covered areas attached to the building.

I understand that acceptance of an offer of employment does not create a contractual obligation upon Goetz Custom Boats to continue to employ me in the future.

Signature (Electronic Signature)

Date

Goetz Custom Boats is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, relation, sex, national origin, sexual preference, age, disability, veteran status or any other status protected by law.

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