First Name
Last Name
SSN#
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
Pager
Email Address
Have you ever applied for membership before?				Yes          No
If Yes, When				Your sponsor was:
Reason for Leaving?
Date of Birth
Are you related (grandparent, parent, brother, sister, child, in-law, cohabitant or spouse), through blood, marriage or adoption, to anyone now or formerly a member of the Seafair Pirates?  Such relationship(s) will not disqualify you from membership.				Yes          No
If Yes, Name				Relationship
Are you a Seattle/Northwest Native?				Yes          No
If no, how long have you resided in the Northwest?				Since:
How did you hear about the Seafair Pirates?
Has a member offered you sponsorship?				Yes          No
Have you been informed of the time commitment and expenses connected with candidacy and membership?				Yes          No
EDUCATION & LIFE EXPERIENCE
High School Diploma?				Yes          No
College/University Diploma?				Yes          No
If yes, Please list institutions & degrees
Trade or Vocational School
Currently Attending:                   Undergraduate School                    Graduate School				Expected completion date
Professional or Technical Licenses:
State(s)				Expiration Date
Certifications
Professional Memberships
Special skills, training, education you have received
Special tools/equipment you are trained to operate
Military service and/or volunteer work
Talents you possess that would be useful as a Seattle Seafair Pirate
Special skills, training, education you have received
Can you sing?				Yes          No
Do you play a musical instrument?				Yes          No
If Yes				I play the:
EMPLOYMENT HISTORY
What is your profession?
Do you believe that your present position will help you contribute to the Seafair Pirates organization?				Yes          No
If yes, how?
Have you discussed becoming a Seafair Pirate with your current employer?  Have you made your employer aware of the possible time commitments involved with being a Seafair Pirate?				Yes          No
May we contact your current employer?				Yes          No
Will your employer support you in your ambition to become a Seafair Pirate?				Yes          No
Please list your present employer and two most recent places of previous employment.
Present Employer
Present Employer Address
Telephone #				Supervisor
Dates			From:		To:
Position & Responsibilities:
Prior Employer
Prior Employer Address
Telephone #				Supervisor
Dates			From:		To:
Position & Responsibilities:
Reason for Leaving:
Prior Employer
Prior Employer Address
Telephone #				Supervisor
Dates			From:		To:
Position & Responsibilities:
Reason for Leaving:
Briefly describe exactly why you want to be a pirate and what you feel being a Seattle Seafair Pirate is all about. Why should we accept you as our newest brother?
List professional, trade, business or civic activities or offices held or any other that might enable you to make a positive contribution to the Seafair Pirates organization
List three references, who are not related to you, who we may contact regarding your personal character and deportment.
Name
Address
Telephone#
Relationship
Name
Address
Telephone#
Relationship
Name
Address
Telephone#
Relationship
Do you have a valid Washington State driver's license?				Yes          No
Commercial Driver’s License?				Yes          No
If yes, list endorsements and expiration dates.
Have you ever been arrested or convicted of a crime?				Yes          No
If yes, explain:
May we investigate your police record/driving history as part of our routine evaluation of your background?				Yes          No
I hereby certify that I am free of felony convictions and outstanding warrants,  I am over twenty-one years of age, and that I am NOT an alcoholic/Habitual Drunkard or Substance Abuser.    Further, I likewise certify that there are no willful misrepresentations, omissions or falsifications in the foregoing statements and answers to questions.    I am aware that should any misrepresentation, omission, or falsification be discovered, my application will be rejected or if I am already a candidate, my membership will be terminated.    I also understand that candidate fees and dues are not refundable as a result of any termination. I agree to the disclaimer above, I am not using this site to advertise another company or website. .Enter "Agree" in this box ->        Signature  Date        SEATTLE SEAFAIR PIRATES  PO Box 30674  Greenwood Station s Seattle, WA 98103

   To Submit Form: First, Print, sign and date result and send to:

    SEATTLE SEAFAIR PIRATES  PO Box 30674  Greenwood Station s Seattle, WA 98103

    Be sure to include a photocopy of your Picture ID 

     To Speed Processing, Click on the Submit Form Button to send unsigned copy  to
      Candidate Review board