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Belle Pass Towing, LLC is an equal opportunity employer. It is our policy to provide equal employment opportunities and applicants for employment without regard to race, color, sex, national origin, age, religion, disability, status as a veteran, or status in any group protected by state or local law. This policy applies to all terms and conditions of employment including, but not limited to, hiring, placement, promotion, termination, leaves of absence, and compensation.

Fields marked with "*" are mandatory

Personal Information

First Name: Middle: Last Name:
SS Number:*	Telephone Number*
Street Address*	Cell Number
City* State Zip Code	Wage / Salary Desired
Years of Experience	Supervisory Experience?	Yes No
Have you ever filed an application with us before?	Yes No, If yes, when?
Have you ever been employed with us before?	Yes No, If yes, when?
Have you ever pled guilty or been convicted of a felony? Yes No If yes, please provide more information.
Are you presently authorized to work in the US? Yes No (Proof of US citizenship or legal authorization to work required upon employment)

Work Preferences

What position are You applying for?*
What dates are you available for employment?		Work Schedule:
Will you work overtime if required?	Yes No
Are you related to any employee or board member of Belle Pass Towing?	Yes No	Explain:

Educational Background

High School Diploma/GED: Year/School:

City/State

College Degree: Year/School:

City/State

Other Certifications/Licenses:

City/State

Describe any job-related training you have received, (if none, state none):

Please provide any additional information such as special skills, training, management experience, equipment operation or qualifications you believe will be helpful to us in considering your application (if none, state none):

Work Experience

Start with most recent or present employer. Complete in full.

Employer Name	Date Employed
Address	Job Title
Phone	Ending Salary
Supervisor	Eligible For Rehire	Yes No
Reason For Leaving:

Employer Name	Date Employed
Address	Job Title
Phone	Ending Salary
Supervisor	Eligible For Rehire	Yes No
Reason For Leaving:

Employer Name	Date Employed
Address	Job Title
Phone	Ending Salary
Supervisor	Eligible For Rehire	Yes No
Reason For Leaving:

References

Do not list relatives or former employers.

Name	City/State	Contact Number	Years Known	Relationship to Applicant

Disclaimer and Signature

I certify that the information given by me in this application is true. I understand that if the information is found to be false in any way, Belle Pass Towing may refuse to employ me or discharge me if I have begun working when it is discovered. I authorize the use of any information in this application to verify my statements, and I authorize my past employers and any other references or persons I have listed to answer all questions asked concerning my ability, character, reputation and previous employment record. I release all such persons from any liability or damages on account of having furnished such information.

I understand that nothing contained in this employment application or in the granting of any interview is intended to create an employment contract or reasonable expectations of employment with Belle Pass Towing. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Belle Pass Towing unless made in writing by an authorized officer of the Company. If an employment relationship is established, I understand that I will be an “at-will” employee and either Belle Pass Towing or I will have the right to terminate my employment at any time, with or without cause.

I understand that if employment is offered, my employment may be conditioned upon the results of a medical examination to ensure my ability to perform the essential functions of the job and that as a condition of employment I will be required to take drug and alcohol screening tests and such medical examinations as may be required by Belle Pass Towing, including physical examination. I agree to submit to these required tests and understand that becoming employed and/or my continued employment are conditional upon the successful passing of these tests in accordance with Company policies and procedures, given reasonable accommodations in accordance with the Americans with Disabilities Act.

If employed, I understand and agree to abide by all Belle Pass Towing policies, procedures, guidelines and training (including, but not limited to, the current Safety Policy) and that my continued employment with Belle Pass Towing is conditioned upon my compliance with, and satisfactory performance of, these requirements. I also understand that Belle Pass Towing may revise these policies, procedures, guidelines and training at any time with or without notice.

I also understand that this application will be kept on active file for thirty (30) days from the date completed, after which time I would have to re-apply in accordance with established Company procedures.

Name/Signature:

Date: