INTRACOASTAL MARINE, INC.
Tug Service and Barge Rental
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Employment
Application for Employment

Please complete the entire application to be considered for employment opportunities.  Applications are considered for all seaman positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, or other protected status.  All applications remain active for a period of one year.

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Cell Phone:
Home Phone:
Email:
Date Available?:
Position for which you are applying?:
Do you have an application on file with ICM already?:
Have you ever been employed here before? If yes, when:
Are you currently working / employed?:
Are you legally eligible for employment in the United States?:
Have you been convicted of a crime (misdemeanor or felony) in the past 10 years? Do not include traffic violations, except DUI charges. A record of conviction does not disqualify an applicant from employment consideration:
If you have been convicted of a crime, please explain:
Are there any restrictions which would prohibit you from interstate travel??:
Do you have an active TWIC?:
Do you have your MMC?: If so REF#
What is your rating / license on your MMC?:
Driver license state of issue and expiration:
Do you have any pending cases with the Coast Guard?:
1. Current or Most Recent Employer:
1. Last Supervisor:
1. Phone Number of Employer:
1. Job title:
1. Job description:
1. Dates employed:
1. Reason for leaving:
1. May we contact this employer?:
2. Employer:
2. Last Supervisor:
2. Phone Number of Employer:
2. Job title:
2. Job description:
2. Dates employed:
2. Reason for leaving:
3. Employer:
3. Last Supervisor:
3. Phone Number of Employer:
3. Job title:
3. Job description:
3.Dates employed:
3.Reason for leaving:
What is your highest level of education completed?:
List any trade schools or special training received:
Do you have knowledge of line handling?:
Are you a certified diver?:
Do you now how to weld?:
Have you done any electrical work?:
List any heavy machinery that you have operated on a regular basis or are certified to operate:
1. Reference Name / Phone Number / Relationship:
2. Reference Name / Phone Number / Relationship:
3. Reference Name / Phone Number / Relationship:
1. Emergency Contact Name / Phone Number / Relationship:
2. Emergency Contact Name / Phone Number / Relationship:
3. Emergency Contact Name / Phone Number / Relationship:
By entering your name, you agree to the following : "I certify that the answers given in this application are true and complete to the best of my knowledge. I attest that I am the applicant, or legal guardian or parent of the applicant. I understand that any false or misleading information given in this application, or in any interview should they occur, will be sufficient cause for denial of employment or immediate dismissal, if employed. By typing my name, I acknowledge and consent to drug testing now, and if hired, often and at random. I further understand that any employment offers will be contingent upon the successful completion of a background investigation. I also understand that I will be required to abide by all rules and regulations of the company and applicable regulatory agencies. I understand that my employment is "at will" and may be terminated at any time by either party. If offered a position within the Company, I understand that the purchasing and wearing of safety shoes and other such equipment to protect myself will be necessary. :
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