Employment Opportunities

Blackmon Mooring, Inc. is an equal opportunity employer and adheres to the principles and practices outlined in Title VII of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, sex, religion or national origin. Public Law 90-202 which prohibits discrimination based on age, and Public Law 101-336 which prohibits discrimination based on disabilities. This policy governs all aspects of employment, including selection, job assignment, compensation, discipline, termination and access to benefits and training. Blackmon Mooring is an E-Verify employer.

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*Last Name

*First Name

M.I.

*Phone (Home)

*Phone (Cell)

*Street Address

*City

*State

*Zip Code

*Email Address

Do you hold a valid driver's license?
Yes No

Do you hold a valid commercial driver's license (CDL)?
Yes No

DL State

Are you over 18?
Yes No

Can you upon hire provide proof of your legal right to work in the United States? Yes No

Position(s) Desired (check all that apply)

Emergency Claims Coordinator/Agent Marketer - San Antonio, Texas
Emergency Response Coordinator - San Antonio, TX
Emergency Response Coordinator - Houston
Project Job Coordinator (Sales) - Midland - Midland/Odessa
Priority Response Consultant (Marketing Representative) - Houston, Texas
Crew Leader & Assistance - Orange County CA - Blackmon Mooring of Southern CA

*Expected Pay $

*Pay Type

*Current Pay $

*Pay Type

*Date Available For Work (MO/YR)

Type of Employment Desired Regular Temporary Full Time Part Time

Have you ever been employed by Blackmon Mooring, Inc.? Yes No

If yes, Where

From

If employed, you agree to comply with Blackmon Mooring, Inc. Safety Policy? Yes No

Do you have charges pending or have admitted guilt or been found guilty including Deferred Adjudication of committing a crime? Yes No

(Include Offenses for which probation, excluding minor traffic violation, but including DWU/DUI)

Answering yes may not automatically disqualify you, but false or omission of information will.

	Name and Location of School	GRADUATE	Degree Earned	Date Granted	Course of Study/Major	GPA
*High School or GED		Yes No
College		Yes No
Other Training		Yes No

Additional Education, Training, Professional Activities or Accomplishments, Skills or Certificates

*What languages do you speak fluently?

Military

Have you ever served in the military? Yes No

Service/Branch

Date Served

Final Rank

Are you a member of a reserve organization? Yes No

An incomplete application will not be considered

*Most Recent Employer

*May We Contact?
Yes No

Phone (Work)

*Supervisor Name

*Start Date (MO/YR)

*End Date (MO/YR)

*Reason for Leaving

*Street Address

*City

*State

Zip Code

*Your Position

*Start Base Pay

*Final Base Pay

*Pay Type

*Describe Major Work Duties

2nd Most Recent Employer

May We Contact?
Yes No

Phone (Work)

Supervisor Name

Start Date (MO/YR)

End Date (MO/YR)

Reason for Leaving

Street Address

City

State

Zip Code

Your Position

Start Base Pay

Final Base Pay

Pay Type

Describe Major Work Duties

3rd Most Recent Employer

May We Contact?
Yes No

Phone (Work)

Supervisor Name

Start Date (MO/YR)

End Date (MO/YR)

Reason for Leaving

Street Address

City

State

Zip Code

Your Position

Start Base Pay

Final Base Pay

Pay Type

Describe Major Work Duties

*Do you have a current passport? Yes No

Attach Resume (*.doc, *.pdf) attachments only

I Certify that all the information provided on this form is true and complete to the best of my knowledge, and I understand that any misrepresentation, falsification, or omission may be considered justification for refusal of employment or subsequent termination. I understand that employment by Blackmon Mooring, Inc. is conditional upon completion of an Employment Agreement. I further understand that my employment is at the discretion of Blackmon Mooring, Inc. and it has no specified term. It can be terminated at will or without notice, at any time, for any or no reason, at the option of either myself or Blackmon Mooring, Inc.

Date of this application

I have read and accepted the above conditions.

Submit

Employment Application

Statement of Policy of Equal Employment Opportunity

Answering yes may not automatically disqualify you, but false or omission of information will.

Military

An incomplete application will not be considered