APPLICANT INFORMATION

First Name (* Required)

Your Last Name (* Required)

Last 4 of social security # (* Required)

Address (* Required)

City, State, Zip (* Required)

Phone Number (* Required)

Your Email (* Required)

Are you a U.S. Citizen (* Required)

How did you hear about us? (* Required)

Referring Person's Name (If referred by someone, please enter their name here.)

LABOR HISTORY

Your Trade (* Required)

Years of shipyard experience (* Required)

Tidewater shipyards or contractor's that will deny you access? (* Required)

Do you have any of the following trade-specific certifications? (* Required)

EMPLOYMENT INFORMATION

Last or Current Employment (* Required)

Please indicate the type of employment history you have.(* Required)

Employer City, State (* Required)

Dates of Employment (* Required)

Position (* Required)

Pay Rate

Reason for Leaving (* Required)


Prior Employment

Please indicate the type of employment history you have.(* Required)

Employer City, State

Dates of Employment

Position

Pay Rate

Reason for Leaving

BACKGROUND INFORMATION

Do you have any of the following convictions? (* Required)

Have you ever had a Government clearance revoked? (* Required)

Do you qualify for Per Diem? (* Required)

If you checked Yes for Per Diem, is the address provided your Tax Home?*? (* Required)

Are there commitments that will interfere with work in the next 30 days? (* Required)

Additional files to upload (* Optional)