EMPLOYMENT APPLICATION

Name *

Date of Appliction *

00/00/0000

Mailing Address *

Phone *

Secondary Phone

Position Applied For *

Date Available *

Are you 18 years of age or older? *

• Yes
• No

Are you eligible to work in the United States? *

• Yes
• No

(proof of eligibility will be required prior to employment)

Have you ever been employed with us before? *

• Yes
• No

If Yes, please give dates of employment and position held

Are you currently employed? *

• Yes
• No

Are you currently on "lay-off" status and subject to recall? *

• Yes
• No

May we contact your present / past employers? *

• Yes
• No

Are you capable of safely preforming the position applied? *

• Yes
• No

(with or without reasonable accommodations)

Have you ever been convicted of a crime, whether a misdemeanor , felony, or otherwise? *

• Yes
• No

(Conviction of a crime does not necessarily disqualify the applicant from consideration for employment)

If yes, please explain:

Education - High School (years completed): *

• 1 Year
• 2 Years
• 3 Years
• 4 Years

choose one

Did you graduate high school? *

• Yes
• No

Education - College (years completed): *

• None
• 1 Year
• 2 Years
• 3 Years
• 4 Years

choose one

Did you earn a degree? *

• Yes
• No

If yes, what degree did you earn?

Employment Experience - Current or most recent employer: *

Employer Address *

Employer Phone *

Supervisor: *

Put N/A if not applicable

Job Title *

Responsibilities *

Dates Employed (start date - end date) *

Hourly Rate / Salary (starting / ending) *

Reason for leaving: *

Put N/A if not applicable

Employment Experience - Employer 2: *

Put N/A if not applicable

Employer 2 Address *

Put N/A if not applicable

Employer 2 Phone *

Put N/A if not applicable

Employer 2 Supervisor

Employer 2 Job Title Held

Employer 2 Responsibilities:

Employer 2 Dates Employed (start date - end date)

Employer 2 Hourly Rate / Salary (starting / ending)

Employer 2 Reason for leaving:

Please summarize any special skills or qualifications:

Shipfitting: *

• High
• Average
• Low
• None

Welding - SMAW *

• High
• Average
• Low
• None

Welding GMAW *

• High
• Average
• Low
• None

Welding FCAW *

• High
• Average
• Low
• None

Welding GTAW *

• High
• Average
• Low
• None

Bouging *

• High
• Average
• Low
• None

Pipefitting *

• High
• Average
• Low
• None

Pipewelding *

• High
• Average
• Low
• None

Blueprint Reading *

• High
• Average
• Low
• None

Grinding *

• High
• Average
• Low
• None

Torch Cutting *

• High
• Average
• Low
• None

Inventory Control *

• High
• Average
• Low
• None

Clerical/Bookkeeping *

• High
• Average
• Low
• None

Drafting/Design Work *

• High
• Average
• Low
• None

Industrial Maintenance Repair *

• High
• Average
• Low
• None

Machining *

• High
• Average
• Low
• None

Outside Machinist *

• High
• Average
• Low
• None

Sandblasting/Spray Painting *

• High
• Average
• Low
• None

Carpentry *

• High
• Average
• Low
• None

Electrical *

• High
• Average
• Low
• None

Professional References *

Please List the name, address, and telephone number of 3 references that are not related to you.

Applicant Signature

This represents your legal signature

Date

00/00/0000

I have read the Applicant's Statment *

• Yes
• No

Please read the Applicant Statement below

Submit

Blount Boats, Inc. affirms that we are an equal opportunity employer. Our Company will not discriminate against employees or applicants on any legally recognized basis including, but not limited to: veteran status, uniform service member, race, color, religion, sex, national origin, age, and physical or mental disability.

APPLICANT’S STATEMENT

I certify that the answers I have provided are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

Neither this application nor any personnel form constitutes a contract. I hereby understand and acknowledge that any employment relationship with this organization is “at will”, which means that the Employee may resign at any time and the Employer may discharge the Employee at any time with or without cause and with or without notice. It is further understood that this “at will” relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. I authorize Blount Boats, Inc. to check and verify all information on the application and fully release the company from any liability resulting from the verification process.