Your Application

REQUIRED FORM

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Contact information

First Name*

Middle Name

Last Name*

Suffix

Street Address*

City

State*

Zip*

Phone 1*

Phone 2

Gender*

Male

Female

Driver's License Number*

Driver's License State*

Expiration Date *

Month*

Date*

Year*

Date of Birth *

Date*

MM slash DD slash YYYY

Email Address*

Social Security Number*

Legal information

Are you at least 18 years of age?*

Have you ever been convicted of a criminal offense which has not been annulled or sealed by a court?*

Please explain*

Have you ever been discharged or asked to resign by an employer?*

Please 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 Number

Certifications: (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)

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 law

Type 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 Company’s 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 Company’s 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 Company’s 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 “at will” nature. I understand that “at will” 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 “at will” 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 Company’s 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 Description

I 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 & Agree

I have read and agree to the above acknowledgments.

Consent

I understand I must email the required forms separately from the top of the application to apply@gulfspan.net.

Yes

Signature*

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*

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