"*" indicates required fields Your Personal InformationYour Name* First Last Phone*Emergency Phone*Email* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Position You're Applying ForPosition(s) Applied For*Date Available for Work* MM slash DD slash YYYY Type of Work Preferred* Full Time Part Time Hours You Are Available for Work*Please tell us what hours you are available for work each day of the week.MondayTuesdayWednesdayThursdayFriday Add RemoveReferral Source* Self School Job Fair Employee PBCB Website Friend Advertisement–Source Other Other, please explain*Name of person who referred you*Are you legally eligible to work in the United States?* Yes No Are you under age 18?*(If yes, you will be required to submit a work permit) Yes No Have you previously filled out an application with Pleasant Bay Community Boating?* Yes No If yes, when?*Were you previously employed by a community boating program?* Yes No If yes, when?*If yes, where?*If related to anyone at Pleasant Bay Community Boating, state name, and relationship:May we contact you at work?* Yes No If yes, work phone #Best time to call*Employment RecordList all previous employers, starting with your most recent employer. Include self-employment, summer and part-time jobs. You may also include any verifiable volunteer work. Please be as accurate as possible since we contact past employers for reference purposes. You may include your resume with this application; however, please also complete this Employment Record section.Employer 1 NameAddress Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor’s Name & Phone #Dates Employed (From: To:)Job Position(s)Duties Performed & Job ResponsibilitiesWhat did you like most about your position?What did you like least about your position?Reason for Leaving?Comments:Employer 2Employer 2 NameAddress Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor’s Name & Phone #Dates Employed (From: To:)Job Position(s)Duties Performed & Job ResponsibilitiesWhat did you like most about your position?What did you like least about your position?Reason for Leaving?Comments:Employer 3Employer 3 NameAddress Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor’s Name & Phone #Dates Employed (From: To:)Job Position(s)Duties Performed & Job ResponsibilitiesWhat did you like most about your position?What did you like least about your position?Reason for Leaving?Comments:Upload Your ResumeUpload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB.Are you employed now?* Yes No If currently employed, why do you desire to change your position?*May we contact your current employer?* Yes No In your current or a prior job, have you ever written instructions or directions to be followed by employees or customers?* Yes No Not Applicable If yes, please explain*Is there any other job-related information you want us to know about you?Job SkillsIndicate and explain job experience you have had in any of the following areas:Aquatics*Camping*Medical*Custodial*Finance*Computer Skills*EducationHigh School/ Prep*School NameCity/StateMajor Course/ SubjectLast Year CompletedDegreeCollegeSchool NameCity/StateMajor Course/ SubjectLast Year CompletedDegreeGraduate WorkSchool NameCity/StateMajor Course/ SubjectLast Year CompletedDegreeOtherSchool NameCity/StateMajor Course/ SubjectLast Year CompletedDegreeReferencesList at least three character references that know you well and can attest to your abilities and suitability for PBCB employment (Under 21, one reference MUST be a family member):Reference 1*NameAddressOccupation/ Relationship to YouPhone# of Years KnownReference 2*NameAddressOccupation/ Relationship to YouPhone# of Years KnownReference 3*NameAddressOccupation/ Relationship to YouPhone# of Years KnownAPPLICANT’S AGREEMENT AND RELEASEEmployment Terms*Employment at Will: I understand and agree that if hired, my employment will be at-will in nature and may be terminated, with or without cause, at any time, by myself or PBCB. I also understand that this written statement supersedes any and all oral representations made by agents or representatives of Pleasant Bay Community Boating. It is my understanding that this employment application, or the granting of an oral interview, does not represent a contract of employment or a promise of future benefits. Release: I hereby authorize any former employer, any person, firm, corporation, school, or any government agency to answer any and all questions and to release or provide any information within their knowledge or records. I agree to hold Pleasant Bay Community Boating and any former employer, any person, firm, corporation, school, or any government agency or any or all of them harmless and free of any liability for releasing any information (whether fact or opinion) that is within their knowledge or records. I agree that a photocopy of this authorization be accepted with the same authority as the original. CORI (Criminal Offender Record Information) & SORI (Sex Offender Registry Information): I understand that Pleasant Bay Community Boating will perform a MA “CORI” and “National SORI” check on me. Employment Authorization: I understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard. Unlawful Discrimination: Pleasant Bay Community Boating does not tolerate unlawful discrimination in its employment practices. Pleasant Bay Community Boating does not tolerate harassment, and no question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment, on the basis of his or her sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state, or local law. Examples of prohibited harassment include, but are not limited to, unwelcome physical contact, offensive gestures, unwelcome comments, jokes, epithets, threats, insults, name-calling, negative stereotyping, possession or display of derogatory pictures or other graphic materials, and any other words or conduct that demean, stigmatize, intimidate, or single out a person because of his or her membership in a protected category. Harassment of our employees is strictly prohibited, whether it is committed by a manager, coworker, subordinate, or non-employee (such as a volunteer, vendor or member). Pleasant Bay Community Boating takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly. I understand that Pleasant Bay Community Boating does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal laws. Truthfulness: I certify that all information provided by me in support of my application for employment is true and correct to the best of my knowledge. I understand that misrepresentations or omissions may be cause for rejection, or may be cause for subsequent dismissal if I am hired. I agree to the above employment terms.Signature*CommentsThis field is for validation purposes and should be left unchanged.