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Gilligan's Boats Employment Application
First Name(*)
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Last Name(*)
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Please provide your contact details below.

Home Address(*)
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City(*)
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State(*)
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Zipcode(*)
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Primary Phone(*)
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Best time to reach you at this number?(*)
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Secondary Phone
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Best time to reach you at this number?
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Email Address
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Please tell us the position you're applying for.

Name of the Job Your Applying for(*)
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Why would you be a good candidate for this job?(*)
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Please provide your employment eligibility information.

What is your date of birth
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What is your Social Security Number?
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If under 18 years of age, can you provide

required proof of your eligibility to work?

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Are you currently employed?
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May we contact present employer?
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Are you prevented from lawfully becoming employed

in this country because of Visa or Immigration Status?

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Are you currently on "lay-off" status and subject to recall?
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Are you available to work?
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On what date would you be available for work?
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Have you ever been convicted of a felony?
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--- If yes, Please explain below
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Do you have any physical reason that would

prevent you from performing the duties of this job?

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--- If yes, Please explain below
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What is your Driver License #?
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Have You Ever Failed a Drug Test?
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Please provide your employer details and employment history.

Your Most Recent Employer
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--- Your Position
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--- Employer Address
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--- Employer Phone
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--- Your Salary
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--- Employer Contact Person
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--- Start and End Dates for Employment here
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Your Next Most Recent Employer
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--- Your Position
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--- Employer Address
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--- Employer Phone
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--- Your Salary
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--- Employer Contact Person
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--- Start and End Dates for Employment here
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Your third Most Recent Employer
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--- Your Position
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--- Employer Address
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--- Employer Phone
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--- Your Salary
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--- Employer Contact Person
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--- Start and End Dates for Employment here
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Please provide personal References information below.

Reference Name
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--- Reference Relation to You
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--- Reference Phone Number
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2nd Reference Name
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--- Reference Relation to You
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--- Reference Phone Number
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3rd Reference Name
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--- Reference Relation to You
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--- Reference Phone Number
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Please provide any additional information about your qualifications below.

Additional Comments Education, Awards, Personal, etc.
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How did you hear about Gilligan's Boats?
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DISCLAIMER I certify that I personally completed this application and that all of the information is true and correct.

I hereby authorize, without liability, any person or organization, including but not limited to any educational institution, training facility or any institution, whose name I have given as a reference, or by whom I have been previously employed to furnish this company any information they may have concerning my character, habits, ability, financial responsibility, job performance, reasons for leaving employment, and all information concerning my employment or training to give such information to other companies and carriers requesting such information. Furthermore, there may be entities that the Company does business with that may request investigative reports or consumer reports which apply to my background. In this case, these reports would apply to my assignment to projects related to the Customer, permission to be on the Customers' premises and to handle its products and other security concerns of the customer. I hereby release all such persons and organizations from any claims for damages of any kind, which may occur to me by reasons of furnishing such information. I hereby authorize any law enforcement agency or court of record to furnish this company information concerning Motor Vehicle Record, or any felony or misdemeanor of which I have been convicted.

Under the authority granted me by 49 CFR Parts 40 and 382, I hereby authorize and require my previous and/or current employers specifically listed as well as any other person or company provided by me in writing or by verbal interview by whom I was employed or to whom I applied for employment in the two year period preceding the date of this application to release the date, type of test and result of all drug and alcohol test taken by me, including the date and type of test for any refusals by me to take a drug or alcohol test, to the individual(s) assigned to process my application at this company. If I tested positive on any controlled substance test, had an alcohol test with a concentration of 0.04 or greater, or refused to take any drug or alcohol test, I also authorize the release of all information concerning my referral to a Substance Abuse Professional (SAP) including all records pertaining to my evaluation and treatment (if required by SAP). I authorize this release by whatever means is most expedient and agree to hold harmless any past employer or any person or company I applied with as well as their employees, agents, or representatives from all liability or damage that may arise from the release of the information specifically authorized here.

I have completed this application of my own free will and hold Gilligan's Boats, it's owners, affiliates, copyright holders and other associated individuals harmless of all liability for providing this application for my use. I also understand that a written and signed version of this release will be required upon successful completion of a phone interview. I also understand I will be required to fill in a long form application for records purposes at orientation if I am selected for this position.

Please click the "Submit My Application" button only once and allow a few moments for the form to process. You will receive a confirmation message that we have received your application. Thank you for your interest in Gilligan's Boats.