Your Application REQUIRED FORM "*" indicates required fields Step 1 of 8 12% Contact information First Name* Middle Name Last Name* Suffix Street Address* City State* AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip* Phone 1* Phone 2 Gender* Male Female Driver's License Number* Driver's License State* AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificExpiration Date *Month*Select monthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDate*Select date12345678910111213141516171819202122232425262728293031Year* Date of Birth *Date* MM slash DD slash YYYY Email Address* Social Security Number* Legal information Are you at least 18 years of age?*YesNoHave you ever been convicted of a criminal offense which has not been annulled or sealed by a court?*NoYesPlease explain* Have you ever been discharged or asked to resign by an employer?*NoYesPlease explain* job positions Please select up to 2 positions that you wish to be considered for from the list.* CRAFT SUPERVISOR EQUIP OPERATOR - TRACKHOE/BACKHOE/DOZER ESTIMATOR FIREGUARD GENERAL MECHANIC BOILERMAKER GENERAL MECHANIC CARPENTER GENERAL MECHANIC IRONWORKER GENERAL MECHANIC MILLWRIGHT GENERAL MECHANIC PIPEFITTER HELPER LABORER NCCER BOILERMAKER NCCER FORM CARPENTER NCCER IRONWORKER NCCER MILLWRIGHT NCCER PIPEFITTER NCCCO/NCCER CRANE OPERATOR NCCCO/NCCER RIGGER PIPE WELDER PLANNER / SCHEDULER PROJECT MANAGER QUALITY SUPERVISOR SAFETY SUPERVISOR STRUCTURAL WELDER TIMEKEEPER / CLERK Please enter your NCCER Number: (optional) Please enter your NCCCO Number: (optional) Education Please list any trade schools you have attended or courses you have taken that may be job-related or that you feel would be of value to this job or company. In the following textbox, please include: Line 1 - Name of the School Line 2 - Location of the School Line 3 - Course of Study Line 4 - Please indicate if you graduated Education 1 (optional)Education 2 (optional)Education 3 (optional)Education 4 (optional) Certifications In the following text box, please include any other licenses or special qualifications. You may list one per line in the following format: License/Certification Name, Issued By, Date Received, Certification/License NumberCertifications: (optional) employment history Please list positions (up to 5) that you have held that are pertinent to the position for which you are applying. In the following textbox, please include: Line 1 - Company Name Line 2 - City, State, Phone # Line 3 - Job Title Line 4 -Dates of Employment, Supervisor's Name Line 5 - Salary, Reason for leaving Most Recent: (optional)Previous Jobs: (optional)Previous Jobs: (optional)Previous Jobs: (optional)Previous Jobs: (optional) Authorization For the release of personal data and record information In connection with my employment, I understand that investigative background inquiries are to be made on myself including: consumer; credit; criminal convictions; motor vehicle; and other reports. The reports will include information as to my character, work habits, performance and experience along with reason for termination of past employment from previous employers. Further, I understand that GULFSPAN INDUSTRIAL or an authorized third party will be requesting information from various Federal, State and other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil and other experiences. I authorize, without reservation, any party or agency contacted by GULFSPAN INDUSTRIAL or an authorized third party to furnish the above-mentioned information. I also understand that this release will be effective for an indefinite period of time unless withdrawn by me in writing such that it will apply to as many employment applications that I may submit to GULFSPAN INDUSTRIAL whether such application are submitted now or in the future. Typing your name into the following textbox constitutes a signature for all purposes described above. Please enter your name and social security number in the following textboxes: Signature* I agree that my typed name below will be as valid as a handwritten signature to the extent allowed by local lawType Your Name Here* Social Security Number* acknowledgments Please read and acknowledge each of the following by placing your initials in the textbox below each statement:Certify I certify that all statements I have made in this application are true and agree that any misrepresentation or omission of facts requested may be sufficient cause for cancelation of my application or immediate dismissal from the Company, if I have been employed. In the event I am employed, I agree to conform to the rules and policies of the Company. I understand that these rules and policies may be changed, interpreted, withdrawn, or added to at the Companyโs option at any time without notice. Physical Exam Consent If I accept a job offer from the Company, I consent and agree to take a physical examination, if required, prior to beginning work. I agree to take such future physical examinations that may be required by the Company. I agree to submit to any lawful drug and alcohol testing, or skills and qualification testing that may be required either as a condition for employment or for continued employment. I understand and agree that refusal to submit to such testing during the course of my employment will result in immediate termination. Background Check I acknowledge the Companyโs notification to me that a background investigation and/or an investigative consumer report on me may be made. I understand and agree that successful completion to the Companyโs satisfaction of such investigation is required for employment or continued employment. I hereby authorize the Company to conduct or have conducted the investigation described above. At Will I understand and agree that if any employment relationship is established with the Company, it will be of an โat willโ nature. I understand that โat willโ means that I may resign at any time and the Company may dismiss me at any time, with or without cause. I understand and agree that this โat willโ employment relationship cannot be changed by any written document or oral statement unless this change is specifically acknowledged in writing by the President or higher level officer of the Company. Wage Liability I agree that the Companyโs liability to me for wages is limited to the amount earned by me as of the date of such termination. I also authorize the Company to deduct at any time any funds. Unauthorized Aliens I understand that federal law prohibits the employment of unauthorized aliens and that all persons hired must submit satisfactory proof of employment authorization and identity. I further understand that the failure to submit such proof will result in my immediate dismissal from the Company if I have been employed. Criminal Disclosure I understand that my disclosure of prior convictions for criminal offenses will not necessarily prevent my employment with the Company; however, the omission of this requested information will be sufficient cause for cancellation of my application or my immediate dismissal from the Company. Job DescriptionI have received a written job description and had the requirements of the job explained to me. I understand these requirements and represent to the Company that I can perform these requirements with or without reasonable accommodation. Read & AgreeI have read and agree to the above acknowledgments. ConsentI understand I must email the required forms separately from the top of the application to apply@gulfspan.net. YesSignature* I agree that all of the above is true and my typed full legal name below will be as valid as a handwritten signature to the extent allowed by local law.Type Your Full Legal Name Here* File Uploads Drop files here or Select files Max. file size: 6 MB. Maximum size per file: 6MB (please load any necessary documents/images here)CAPTCHA
