Internship Application Form – Open Waters Louisiana

Applicant Full Legal Name

First

Last

Today's Date

Your Date of Birth

High School

GPA

Last Grade Level Completed

Street Address

City

State

Zip

Phone

Email

Type of Internship Desired

Full Time

Part Time

Date you will be available to start work

Are you able to meet the attendance requirements?

Yes

No

Do you have any objection to working overtime if necessary?

Yes

No

Can you travel if required by this position?

Yes

No

Have you ever been previously employed by our organization?

Yes

No

Can you submit proof of legal employment authorization and identity?

Yes

No

If you are under 18, can you furnish a work perm it if it is required?

Yes

No

How did you hear about this program?

Please describe your prior experience working in and near waterways (100-150 words)

Employment History

Employer #1

Employer

Position

Address

Phone

Supervisor Name & Title

Start Date

End Date

Job summary

Reason for leaving

Employer #2

Employer

Position

Address

Phone

Supervisor Name & Title

Start Date

End Date

Job summary

Reason for leaving

Other Skills and Qualifications

Summarize any job-related training, skills, licenses, certificates, and/or other qualifications

References

List 3 references names, telephone numbers, and years known (do not include relatives or employers):

Name

Phone

Email

Years Known

Name

Phone

Email

Years Known

Name

Phone

Email

Years Known

Essay

In 250-300 words, describe why you are interested in an internship in the Maritime Industry and what makes you an outstanding candidate.

Acknowledgements

We are an equal opportunity employer and do not unlawfully discriminate in employment or internships. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for intern ship on a basis prohibited by local, state, or federal law. Equal access to employment, internship, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.

By signing below, you agree to the following:

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.
I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of internship if I am employed, whenever it may be discovered.
If I am employed as an intern, I acknowledge that there is no specified length of employment/internship and that this application does not constitute an agreement or contract for employment/internship. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.
I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.
I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

I represent and warrant that I have read and fully understand the foregoing, and that I seek an internship under these conditions.

Name

First

Last

Date