IntraTug Online Careers Application Form

IntraTug Online Career Application Form

Please fill out the form completely and accurately. Incorrect or falsified information can interfere with your eligibility for employment or lead to dismissal. This is a four-part form. It will help you to have your education information, past work history and professional references handy. Thank you for your time in completing this application.

Anything marked with * is a required field.

APPLICANT INFORMATION

Phone: *

Full Name: *

Address: *

Street, City, State and ZIP Code

Position Applying For: *

Desired Pay Rate: *

Date Available for Work: *

Have You Ever Worked for IntraTug? *

If Yes, When Did You Work for IntraTug?

Are You a Citizen of the United States? *

If No, Visa or Alien Card Number:

Do You Hold a Valid Merchant Mariner's Document *

If Yes, Reference Number:

If Yes, Expiration Date of Card

If Yes, Type of License/Capacity/Limitations:

Do You Have a Valid Driver's License? *

If Yes, Driver's License Number

Do You Have a Valid State ID? *

If Yes, ID Number

Do You Have a Valid TWIC Card? *

If Yes, Expiration Date of TWIC Card:

List Your Valid Training Certifications:

Describe Your Skills / Experience: *

PREVIOUS EMPLOYMENT REFERENCE 1

Please include your first company reference information below. Note that all fields in references section 1 are required with the exception of the fax field.

Company: *

Phone: *

Address: *

Street, City, State and ZIP Code

Job Title: *

Supervisor

Employed From: *

Employed To: *

Job Responsibilities:

Reason for Leaving: *

May we contact your previous supervisor for a reference? *

PREVIOUS EMPLOYMENT REFERENCE 2

Please include your second company reference information below.

Company:

Phone:

Address:

Street, City, State and ZIP Code

Job Title:

Supervisor:

Employed From:

Employed To:

Job Responsibilities:

Reason for Leaving:

May we contact your previous supervisor for a reference?

PREVIOUS EMPLOYMENT REFERENCE 3

Please include your third company reference information below.

Company:

Phone:

Address:

Street, City, State and ZIP Code

Job Title:

Supervisor:

Job Responsibilities:

Employed From:

Employed To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

MILITARY SERVICE

Have You Served in the Military: *

Military Service From:

Military Service To:

Branch of Military:

Rank at Discharge:

Type of Discharge:

How Did You Hear About Intratug?

Resume

Select File

Cancel

Upload Any Training Certificates or Credentials

Select File

Cancel

Additional Training Certificates

Select File

Cancel

Additional Training Certificates

Select File

Cancel

Signature Certification *

I Certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

I CERTIFY