BRUCE OAKLEY APPLICATION

Welcome to the Bruce Oakley Application Form!

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First Name

Last Name

Last 4 of SSN

Location

Position

SSN

Date of Birth*

First Name

Middle

Last Name

Email

Mobile Number

Other Number

Pay Expected

Begin Working For Oakley

Have you ever applied for employment with us?

Yes No

Are you available for full-time work?

Yes No

Will you work overtime if needed?

Yes No

Are you legally eligible for employment in the United States?

Yes No

Other Special Training or Skills (Language, Machine Operations, etc.)

Address

Street

City

State

Zip

* The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40, but less than 70 years of age.

Please list your Education Information.

Please list your Employment History.

APPLICANT DRUG & ALCOHOL SCREEN AND SEARCH AUTHORIZATION FORM

I authorize BRUCE OAKLEY, INC., to conduct medical examinations, drug and alcohol screening tests from time to time, prior to and during employment as a condition of initial and continued employment. I also consent to searches of my person and belongings and property on Company property, upon request, as a further condition of employment. As a condition of employment, I understand that I may be required to pass a physical examination. I understand that a urine, breath, blood and/or saliva screening test to determine the presence of certain drugs and/or alcohol may be included in that physical examination. Further, during my employment, if hired, I may be requested to undergo the same screening tests and searches of my person and belongings from time to time. As an applicant, I understand that the presence of alcohol and/or drugs will disqualify me from further consideration for employment. If employed, I understand that the presence of alcohol and/or drugs in my possession or in my system while on the job will be cause for immediate termination of employment. I voluntarily consent to all such examinations, tests, searches, and release BRUCE OAKLEY, INC., its officers, employees, and agent from any claims arising from (and any information obtained from) such examinations, tests or the information obtained therefrom.

Your signature will be used here if accepted.

(READ THE FOLLOWING CAREFULLY BEFORE SIGNING)

I certify that the answers supplied by me on this application are true and complete, without any material omissions, I understand that any false statements or material omissions in this application will be grounds for cancellation of the application and/or dismissal from the Company’s service if I have been employed. I understand that if employed, my employment will be for an indefinite period of time, and that I may terminate my employment at any time for any reason, and that the Company may do likewise; I further understand that no representative of the Company has authority to enter into any agreement to the contrary, unless such agreement is in writing and signed by the President of the Company. This is to inform you that an investigation may be made whereby information is obtained through personal interviews with your neighbors, friends, and others with whom you are acquainted, and that such inquiry may include information as to your character, general reputation, personal characteristics or mode of living, which will be used for employment purposes. You have the right to make a written request within a reasonable period of time for a disclosure concerning the nature and scope of this investigation. I authorize the Company to investigate the information contained in this application; I further authorize the former employers listed above to give to you any and all information concerning my previous employment, and I release all parties from liability as a result of such disclosures. I agree, if employed and an injury or illness occurs while working, to provide the Company access to all medical records related to the diagnosis and treatment of the injury or illness. I understand I may be required to take a qualification test, based on the requirements of the position, and hold harmless the Company for any injury incurred during such test. I have read and signed the applicant drug and alcohol screen and search authorization form. If employed, I agree to allow the company to deduct from my wages any monies owed to the Company for tools, equipment, uniforms and/or wage advances. Should I be hired, I understand that if I quit or I am terminated from my job with BRUCE OAKLEY, INC. for any reason within 90 days of my hire date, I will be responsible for the entire cost of the pre-employment physical and drug screen. I authorize BRUCE OAKLEY, INC., to deduct the cost of the pre-employment physical and drug screen through payroll deduction of my payroll check. I understand that should I leave the vessel to which I am assigned for any personal reason other than those covered by BRUCE OAKLEY, INC., policy, I will assume financial responsibility for my travel. I understand that this application will be active for only 30 days from the date below. After 30 days, I understand I must personally come in and renew my application in order for it to be considered.

BRUCE OAKLEY APPLICATION

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APPLICANT DRUG & ALCOHOL SCREEN AND SEARCH AUTHORIZATION FORM