KRAA: Kodiak Regional Aquaculture Association On-Line Job Application
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*Are you over the age of 18?
*Are you a U.S Citizen or do you have
a legal right to work in the U.S?
*Willing to work: Full time

Non-Standard Hours
*Able to work overtime
*Able to lift 50lbs &
carry distances of up to 100 yards
Position Applying For:
*Please Specify
Education-Training
Please type None or NA for the fields that do not apply to you.
High School City State Graduated?
College/University City State Degree and Major Graduated?
College/University City State Degree and Major Graduated?
Employment History
Please enter your most recent position first. If no employment history please enter "none."
Job 1
*Employer's Name
*Employer Phone # ()
*Address
*City
*State
*Zip
*Starting Date Mo/Year /
Ending Date Mo/Year /
*Supervisor's Name
*Supervisor's Phone # ()
*Currently Employed?
*May we contact?
*Starting Title
Starting Salary
*Ending Title
*Ending Salary
*Reason for Leaving
Name(s) used during this job
*Primary Job Duties
Job 2
Employers Name
Employer Phone # ()
Address
City
State
Starting Date Mo/Year /
Ending Date Mo/Year /
Starting Title
Starting Salary
Ending Title
Ending Salary
Reason for Leaving
Name(s) used during this job
Primary Job Duties
Job 3
Employer's Name
Employer Phone # ()
Address
City
State
Starting Date Mo/Year /
Ending Date Mo/Year /
Starting Title
Starting Salary
Ending Title
Ending Salary
Reason for Leaving
Name(s) used during this job
Primary Job Duties
References
Please list three references, not listed above -
include name, relationship, company, title if applicable and contact phone number(s) and email address if available.
Please use the space below to copy and paste your resume or list any other job-related training, experience, or accomplishments pertinent to this position. (Please provide a résumé or type N/A or None for no résumé)
Voluntary Affirmative Action Information
In compliance with federal regulations, the company is required to gather and maintain statistics for use in completing its annual Affirmative Action Report. The information is voluntary, confidential, and will be filed seperately from the application form. We appreciate your assistance in providing us with this information. Thank you.

Ethnicity:
Yes   No

Hispanic or Latino.
A person of Cuban, Mexican, Puerto Rican,South or Central American, or other Spanish culture or origin, regardless of race.
Race: If you selected "No" above, please select one of the following categories
White A person having origins in any of the original peoples of Europe, the Middle East or North America.
Black or African American A person having origins in any of the Black racial groups of Africa.
Native Hawaiian or Other Pacific Islander A person having origins in any of the original peoples of Hawaii,Guam, Samoa, or other Pacific Islands.
Asian A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Island, Thailand, and Vietnam.
American Indian or Alaska Native A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Two or More Races All persons who identify with more than one of the above five races.


IMPORTANT: Before submitting, please check this application carefully for completeness and for agreement to the conditions described below. This application is not complete until the following statements have been read and the form is submitted.

1. EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION: Kodiak Regional Aquaculture Association is an equal employment opportunity employer and does not discriminate on the basis of age, race, color, national origin, sex, marital status, sexual orientation, religion, disability or veteran status or any other legally protected status. I understand that Kodiak Regional Aquaculture Association is committed to a program of Equal Opportunity and Affirmative Action in all its personnel practices. I agree to support the company’s efforts in ensuring Equal Employment Opportunity and Affirmative Action for all employees. If I am hired I agree to abide by all policies and regulations of this company.

2. APPLICATION MISREPRESENTATION: I hereby affirm that the information provided on this application (and accompanying résumé, if any) is true and complete to the best of my knowledge. I understand that any falsified information or omissions will disqualify me from further consideration for employment and may also result in my dismissal if discovered at a later date.

3. IMMIGRATION REFORM ACT: I understand that according to the Immigration Reform and Control Act of 1986 all individuals who are hired must, as a condition of employment, produce certain documentation to verify their identity and their legal authorization to work in the U.S. As a consequence, I understand that any offer of employment would be contingent on my ability to produce the required documentation within the time period required by law.

4. REFERENCES AUTHORIZED:I authorize a thorough investigation of my past employment and activities and understand that KRAA: Kodiak Regional Aquaculture Association may request a criminal history and fingerprint security investigation in addition to verifying Social Security number, education and other certifications with continued employment contingent upon the results of that investigation. I agree to cooperate in such investigation, and release from all liability or responsibility all persons and corporations requesting or supplying such information.


By clicking the SUBMIT APPLICATION button below, I certify that my responses to the questions on this application are true and agree to the statements above.

*Signature
Date


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