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Employment Application – Billeter Marine Coos Bay Oregon
Request a Quote
Employment Application

APPLICANT INFORMATION

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Are you citizen of the United States
If no, are you authorized to work in the U.S.?
Have you ever worked for this company?
Have you ever been convicted of a felony?
Do you have a valid Oregon Drivers License?

EDUCATION

Did you graduate?
Did you graduate?
Did you graduate?

REFERENCES

Please list three personal references.
Full Name
Full Name
First
Last
Full Name
Full Name
First
Last
Full Name
Full Name
First
Last

EMERGENCY CONTACT INFORMATION

Full Name
Full Name
First
Last

PREVIOUS EMPLOYMENT

May we contact your previous supervisor for a reference?
May we contact your previous supervisor for a reference?
May we contact your previous supervisor for a reference?

MILITARY SERVICE

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Billeter | 520 3rd Court, Coos Bay, OR 97420 | Phone: 541-269-8600
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