| Town of Oak Bluffs Marina Job Application PO Box 1327, Oak Bluffs, MA 02557 |
| Position applying for: | ||||
| Shift Supervisor | Dock Attendant | Mooring Attendant | Launch Captain | Crowd Control |
| Full Name: |
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Social Security: |
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| Permanent Address: |
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| Island Address: |
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| EDUCATION | Name of School | Year Graduated | Concentration |
| High School | |||
| College |
| Previous Employ | Position | Dates from/to: | Contact Name | Phone/Address |
| Personal Reference | Phone | Address | Relationship to Applicant |
| Emergency Contact* | Phone | Address - Physical (Street) | Relationship to Applicant |
| * Someone we can contact in case of emergency on the job. |
| Work Experience (list other pertinent job experience for job applied for): |
| Licenses or Certificates you possess: |
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Driver's License Boating Safety Course - Date: __________ Lifeguard |
CPR USCG License - Date: __________ Other: _______________________ |
| Can you swim? Yes No | Start Work Date: ________________ End Work Date: ________________ |
| Comments: |
| I certify that the above information is correct and complete to the best of my knowledge. It is agreed that any misrepresentation or omission of pertinent facts may be considered cause for termination or the withdrawal of an offer for employment. The Town of Oak Bluffs is an equal opportunity employer. |
| Signature of Applicant: _________________________________________ | Date: _______________ |