ASC Employee Referral Form

To be completed by current employee

Your First Name *

Your Middle Name

Your Last Name *

Your Vessel *

Your Email Address *

Your Phone Number *

First and Last Name of Referral *

Relationship to Referral *

Acknowledgment

I have read and understand the ASC Employee Referral Program. I understand that if the candidate I refer is hired because of my referral, I will receive a bonus of $500 after the completion of their first at[1]sea trip and another $500 after the completion of their first at-sea contract with a minimum of four trips has been completed. Additionally, the candidate must separate from the vessel in good standing with the company. All bonuses are subject to applicable taxes and deductions.

Signature *

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Date * +