Crounse - Apply OnLine - CrounsePortal

We appreciate your interest in our Company and assure you that your complete answers to all questions on this application will best serve our mutual interests.

A REAFFIRMATION OF COMPANY EMPLOYMENT POLICY

This is to notify all concerned that the policy of this Company is to provide equal employment opportunity without regard to race, color, religion, sex or national origin. This policy applies to all employees and applicants for our employment in connection with:

Hiring, placement, upgrading, transfer or demotion;
Recruiting, advertising or solicitation for employment;
Treatment during employment;
Rates of pay or other forms of compensation;
Selection for training including apprenticeship;
Layoff or termination;

The Company is a government contractor and an Affirmative Action/EEO employer.

Personal Information

First Name:*

Middle Name:

Last Name:*

Phone #:*

Email:

Are you legal to work in the US:*

Do you have a valid drivers license:*

Address History

Yrs at Current Addr.:*

Current Street #:*

Current Street:*

Current City:*

Current State:*

Current Zip Code:*

Yrs at Previous Addr.:

Previous Street #:

Previous Street:

Previous City:

Previous State:

Previous Zip Code:

Employment Desired

Pos. Applied For:*

Date you can start:*

Will you work extra days if requested? *

Have you previously applied for employment with us? *

Previous applied date?

Previous applied where?

How did you hear about us? *

Other Note

Employment History

1.

Name:

Street #:

Street:

City:

State:

Zip Code:

Type of Work:

From :

To :

Starting Salary:

Ending Salary:

Supervisor Name:

Reason for Leaving:

If above job was on a boat, answer the following questions:

Boat Name:

River(s):

Horsepower:

Days On:

Days Off:

2.

Name:

Street #:

Street:

City:

State:

Zip Code:

Type of Work:

From :

To :

Starting Salary:

Ending Salary:

Supervisor Name:

Reason for Leaving:

If above job was on a boat, answer the following questions:

Boat Name:

River(s):

Horsepower:

Days On:

Days Off:

3.

Name:

Street #:

Street:

City:

State:

Zip Code:

Type of Work:

From :

To :

Starting Salary:

Ending Salary:

Supervisor Name:

Reason for Leaving:

If above job was on a boat, answer the following questions:

Boat Name:

River(s):

Horsepower:

Days On:

Days Off:

May we contact these employers? If not explain:

List any friends or relatives employed by Crounse Corporation:

1.

2.

3.

Personal References(Do not list relatives or former employers):

1. Name:*

1. Phone:*

2. Name:*

2. Phone:*

3. Name:*

3. Phone:*

Education

High School

Name:*

City:*

State:*

Diploma:*

Vocational/Trade School

Name:

City:

State:

Diploma:

College

College Name:

City:

State:

Degree:

Degree In:

Start Date:

End Date:

If more than one college or degree, please include the additional information below.

Military Service

Branch:

Rank:

Status:

From:

To:

If discharged, and your discharge was anything other than honorable, please explain:

Criminal History

Have you ever been convicted of a crime:*

If yes explain:

Authorization:

I certify, under penalty of immediate dismissal, that all above information is true and correct, and you are hereby authorized to make any investigation of same, including, but not limited to, investigations into prior criminal charges or convictions, motor vehicle driving records, and education records. I further certify that I understand the policy of Crounse Corporation forbids illegal drugs, alcoholic beverages, and firearms in corporate vehicles and on its vessels. I also understand that random blood or urine tests will be conducted on the vessels or at an appropriate site to determine whether employees are under the influence of alcohol or drugs. If employed, I hereby authorize Crounse Corporation management personnel and/or their represenatatives to conduct such random blood or urine tests or searches of my personal belongings, if nececssary, to assure compliance with this policy.

I authorize the release of records containing drug and/or alcohol testing results to any future employer upon their request. Additionally, I authorize the release of any employment-related information including, but not limited to, drug and/or alcohol testing results from any previous employer to Crounse Corporation upon their request.

Checking the box below acknowledges that you have read, understand and agree to all of the above statements.