Employment Application

Ready To Join Our Team?

Please fill out the form below to initiate the hiring process. Once we receive your submission, we will contact you with further information regarding the hiring process. In the event that you do not hear back from us, you either did not meet our qualifications or we do not currently have a placement for your skillset. However, we will keep your information on file for future use.

Full Name (First & Last): *

Social Security No:

Phone 1: *

Phone 2:

Street Address: *

How Long?:

City: *

State: *

Zip: *

Permanent Address:

How Long?:

City:

State:

Zip:

Are 18 Years Or Older?

Are you prevented from lawfully becoming employed in this country?

Are You Willing To Work Night Shifts?

Position Applied for:

Desired Pay Rate:

Date You Can Start?

Are You Currently Employed?

May We Contact Your Current Employer?

Have You Ever Applied To This Company Before?

If so, when?

Referred By:

Do You Have Reliable Transportation?

EDUCATION

High School Name & Location:

Number Of Years Attended?

Did You Graduate?

Subjects Studied:

College Name & Location:

Number Of Years Attended?

Did You Graduate?

Subjects Studied:

Technical or Other Name & Location:

Number Of Years Attended?

Did You Graduate?

Subjects Studied:

SKILLS & ADDITIONAL INFO

List All Skills (Tig, Stick, Flux Core, Etc.):

Classification (1st, 2nd, 3rd, etc):

Any Other Info That May Be Beneficial?

PREVIOUS WORK EXPERIENCE: Most Recent or Current Employer

Company Name & Address:

Position:

Start Date:

End Date:

Previous Wages:

Reason For leaving:

PREVIOUS WORK EXPERIENCE: Additional Employer 2

Company Name & Address:

Position:

Start Date:

End Date:

Previous Wages:

Reason For leaving:

PREVIOUS WORK EXPERIENCE: Additional Employer 3

Company Name & Address:

Position:

Start Date:

End Date:

Previous Wages:

Reason For leaving:

REFERENCES: Provide Three Persons Not Related To You, Whom You Have Known For At Least One Year

Full name:

Address:

Business Name:

Years Aquatinted:

Full name:

Address:

Business Name:

Years Aquatinted:

Full name:

Address:

Business Name:

Years Aquatinted:

EMERGENCY CONTACT

Name:

Address:

Phone:

CREDENTIALS

Upload a copy of all credentials (front & back):

As per Louisiana Law, Coastal Manpower, LLC can deduct from your payroll the following expense if you are terminated within 45 days of your employment date. This includes voluntary quitting or terminted for any just case. They are as follows:

Cost of your physical exam and administration expenses.

Signature (type in full name): *

Date/Time

Looking For A Career With A Great Company?

Join Our Team!

Employment Application

Ready To Join Our Team?

Looking For A Career With A Great Company?

GIVE US A CALL

LINKS

CONTACT INFO