PERSONAL INFORMATION



Are you 18 years of age or older?
YesNo


Do you have a valid driver's license?
YesNo


Do you have an original social security card?



Do you hold any Merchant Marine documents?
YesNo

Veteran?
YesNo

Can you swim?
YesNo


Are you able to work outdoors in adverse weather conditions?
YesNo

Do you have more than 2 traffic tickets within the last 3 years?
YesNo


Have you had a DWI in the last 5 years?
YesNo


Are you currently on probation or have any charges pending?
YesNo

Have you ever been convicted or charged of a felony?
YesNo
If so, date:

** Note: A conviction nor probation does not necessarily eliminate you from consideration. Each conviction will be reviewed with respect to the offense and position for which you apply.

EMPLOYMENT INFORMATION

Have you ever applied or been employed for Big River Shipbuilders/Yazoo River Towing?
YesNo
If so, date:


Offered?
YesNo


Are you currently employed?
YesNo



If so, may we contact your current employer?
YesNo

EMPLOYMENT HISTORY

List below your last five employers, starting with the most recent

Date Employer Phone Number Supervisor Wage Position Reason for Leaving
From: To:
From: To:
From: To:
From: To:
From: To:


REFERENCES

List below three people not related to you, whom you have known at least one year

Name Phone Number Position Years Acquainted


EDUCATION AND CERTIFICATIONS














Upload a resume and/or certification and training documents:






AUTHORIZATION

*Big River Shipbuilders is an equal employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion, handicap or national origin.

I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the company. I understand that any employment is conditioned on a background check. I authorize the company to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the company, without giving me prior notice of such disclosure. In addition, I release the company, any former employers and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure. I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be “at will” and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the company unless made in writing by an authorized company representative. If I am offered employment I agree to submit to a medical examination and drug test, before starting work. If employed, I also agree to submit a medical examination or drug test at any time deemed appropriate by the company and as permitted by law. I consent to such examinations and tests, and I request that the examining doctor disclose to the company the results of the examination, which results shall remain confidential and segregated from my personnel file, I understand that my employment or continued employment, to the extent permitted by law, is contingent upon satisfactory medical examinations and drug test; and if I am hired a condition of my employment will be that abide by the Company’s Drug and Alcohol Policy. I understand that acceptance of this form does not indicate there is a position open and does not obligate the company to hire. If hired, I agree to abide by all company work rules, policies and procedures. The company retains the right to revise its policies or procedures, in whole or in part, at any time.