If you are human, leave this field blank. Full Name * Address (include city, state & zip) * W2 will be sent to this address Local Address (include city, state & zip) if applicable Home Phone * Cell Phone * Local Phone Email * Position Applying For: * Age * 16 or over 18 or over Type of Availability? * Part Time Full Time Dates of Availability (from/to) * High School Education Name & Address Years attended from - to Diploma? Yes No College Education Name & Address Years attended from - to Diploma? Yes No Information for applicants - It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Employment History Including volunteer work. List most recent first. Company Name Company Address Company Phone Number Employed From / To month/year Position Supervisor's Name Reason for leaving Company Name Company Address Company Phone Number Employed From / To month/year Position Supervisor's Name Reason for leaving Company Name Company Address Company Phone Number Employed From / To month/year Position Supervisor's Name Reason for leaving If not listed above, have you worked for Hy-Line before? If so, when? How did you hear about this job opportunity? Name of Reference Relationship Phone Number Name of Reference Relationship Phone Number Name of Reference Relationship Phone Number Relatives or friends employed by Hy-Line The information I have provided in this application is true and complete. I understand that any false statement or significant omission by me in the application or application process may be grounds for denial of employment or for immediate dismissal if discovered at a later date. * I authorize Hy-Line Cruises to verify any and all information contained within this application Yes No
