East Brother Light Station, Inc.

(A Not-For-Profit Corporation)

117 Park Place, Point Richmond, CA 94801

(This may be returned preferably via email to tom.butt@intres.com. It may also be completed, printed and faxed to 510/232-5325)

This organization is an Affirmative Action/Equal Opportunity Employer

APPLICATION FOR EMPLOYMENT FOR THE POSITION OF KEEPERS

STOP AND READ THIS FIRST:

This is a MS WORD template. Fill it in by typing over the text in the shades areas. Save it as an MS WORD file or a pdf file and email it to tom.butt@intres.com with any attachments.

One of the applicants must have an active U.S Coast Guard Captain’s License. If you do not have this, do not apply. You will be wasting our time and yours.

Neither of the applicants is allowed to be smokers. If you currently smoke, do not apply.

Attach separately or preferably send a scanned copy as a pdf file of your Coast Guard license.

Attach separately or preferably send a pdf file of any more detailed resumes or other supporting documents of information that may be helpful in evaluating qualifications.

See the end of the form for answers to Frequently Asked Questions. Please submit any questions via email to tom.butt@intres.com. Do not make any inquiries to anyone via phone.

APPLICANT No. 1

PERSONAL INFORMATION

Name: Type your first and last name here

Social security Number: XXX XX XXXX

Current Address: City, State and Zip

Home Phone: XXX XXX XXXX

Cell Phone: XXX XXX XXXX

EDUCATION (Most recent first)

School # 1: Name of school, degree, dates and honors

School # 2: Name of school, degree, dates and honors

School # 3: Name of school, degree, dates and honors

MILITARY SERVICE

Assignment #1: List Dates, Branch and rank

Assignment #2: List Dates, Branch and rank

Assignment #3: List Dates, Branch and rank

EMPLOYMENT EXPERIENCE (Most recent first)

Employment #1

Dates: from Year to Year

Employer: List name and address of employer and nature of business

Your Position: Title and Description of Duties

Compensation: Enter salary in per hour or per year format

Immediate Supervisor: List name, address, phone number and email

Reason for Leaving: Enter reason for leaving

Can reference be contacted: Yes or No

Employment #2

Dates: from Year to Year

Employer: List name and address of employer and nature of business

Your Position: Title and Description of Duties

Compensation: Enter salary in per hour or per year format

Immediate Supervisor: List name, address, phone number and email

Reason for Leaving: Enter reason for leaving

Can reference be contacted: Yes or No

Employment #3

Dates: from Year to Year

Employer: List name and address of employer and nature of business

Your Position: Title and Description of Duties

Compensation: Enter salary in per hour or per year format

Immediate Supervisor: List name, address, phone number and email

Reason for Leaving: Enter reason for leaving

Can reference be contacted: Yes or No

OTHER EXPERIENCE: Describe any other experience or additional qualifications that you believe would qualify you for this position

OTHER

Have you ever been convicted of a felony (excluding sealed or expunged conviction)? Yes or No

If so Explain: Provide full explnation, including felony, location of conviction and disposition

Do you have any physical, emotional or mental condition that may affect your ability to perform this job? Explain nature of condition or diability and how it might be accommodated

REFERENCES (Three individuals not related to you and not former employers whom you have known for at least one year:

Reference #1: Name, address, phone and email. Years known. Employment, title or other identification.

Reference #2: Name, address, phone and email. Years known. Employment, title or other identification.

Reference #3: Name, address, phone and email. Years known. Employment, title or other identification.

EMERGENCY: In case of emergency, notify: Name, address and phone number

APPLICANT No. 2

PERSONAL INFORMATION

Name: Type your first and last name here

Social security Number: XXX XX XXXX

Current Address: City, State and Zip

Home Phone: XXX XXX XXXX

Cell Phone: XXX XXX XXXX

EDUCATION (Most recent first)

School # 1: Name of school, degree, dates and honors

School # 2: Name of school, degree, dates and honors

School # 3: Name of school, degree, dates and honors

MILITARY SERVICE

Assignment #1: List Dates, Branch and rank

Assignment #2: List Dates, Branch and rank

Assignment #3: List Dates, Branch and rank

EMPLOYMENT EXPERIENCE (Most recent first)

Employment #1

Dates: from Year to Year

Employer: List name and address of employer and nature of business

Your Position: Title and Description of Duties

Compensation: Enter salary in per hour or per year format

Immediate Supervisor: List name, address, phone number and email

Reason for Leaving: Enter reason for leaving

Can reference be contacted: Yes or No

Employment #2

Dates: from Year to Year

Employer: List name and address of employer and nature of business

Your Position: Title and Description of Duties

Compensation: Enter salary in per hour or per year format

Immediate Supervisor: List name, address, phone number and email

Reason for Leaving: Enter reason for leaving

Can reference be contacted: Yes or No

Employment #3

Dates: from Year to Year

Employer: List name and address of employer and nature of business

Your Position: Title and Description of Duties

Compensation: Enter salary in per hour or per year format

Immediate Supervisor: List name, address, phone number and email

Reason for Leaving: Enter reason for leaving

Can reference be contacted: Yes or No

OTHER EXPERIENCE: Describe any other experience or additional qualifications that you believe would qualify you for this position

OTHER

Have you ever been convicted of a felony (excluding sealed or expunged conviction)? Yes or No

If so Explain: Provide full explnation, including felony, location of conviction and disposition

Do you have any physical, emotional or mental condition that may affect your ability to perform this job? Explain nature of condition or diability and how it might be accommodated

REFERENCES (Three individuals not related to you and not former employers whom you have known for at least one year:

Reference #1: Name, address, phone and email. Years known. Employment, title or other identification.

Reference #2: Name, address, phone and email. Years known. Employment, title or other identification.

Reference #3: Name, address, phone and email. Years known. Employment, title or other identification.

EMERGENCY: In case of emergency, notify: Name, address and phone number

STATEMENT OF INTEREST AND PURPOSE

Describe why you would like to have this position and why you believe you would perform the job well

ACKNOWLEDGMENT

I Understand and Acknowledge The Following:

If I am offered employment, I will, as a condition of employment, be required to submit proof of my identity and legal right to work in the U.S.

I understand that, if I am employed, any false statement, misrepresentation, or omission of facts on this application or on any supporting documents may result in my immediate dismissal.

I understand that I will be required to possess a current and valid California driver's license.

I understand and agree that, if I am offered a position, it will be offered on condition that my employment shall be at will and for no definite period, and that my employment may be terminated at any time with or without cause and with or without prior notice.

I understand that no supervisor or manager may alter or amend the above conditions except in writing.

I authorize investigation of all statements contained in this application and any supporting documents. I authorize the Company to secure information about my experience from former employers, educational institutions, government agencies, or any references I have provided and for those parties to provide information concerning my experience and I hereby release all parties from any liability arising from such investigation.

If asked to interview, I understand this form must be signed.

Names: Enter names of applicants

Date: Enter date this form was completed

FREQUENTLY ASKED QUESTIONS

Can you provide a detailed Job Description?

The Lighthouse Keepers are a "couple" who, as employees of the organization, manage and run the bed and breakfast inn and day use programs at East Brother Island. The five-room inn is currently open four evenings a week, Thursday through Sunday, and the island is available for day use visitors on summer weekends. Duties include boat transportation, tours, dinner and breakfast preparation and serving, and cleaning. Assistance with island maintenance is by a volunteer group. A copy of the Personnel Manual is available on request.

Define what you mean by "couple?"

We use the word "couple" loosely, because the job requires two persons who must live and work together in close quarters. They do not necessarily have to be a married couple.

What are the minimum Qualifications

One of the individuals must possess a valid U.S. Coast Guard commercial operators license for a boat carrying at least six passengers. If you do not have this, please do not waste your time and ours by applying. Keepers must have culinary experience or abilities, must be warm and presentable to the public, and must be enthusiastic and self-motivated. Children are incompatible with this job, as are pets. Smoking is not permitted. Previous food service or hotel type experience may be helpful but is not required.

How can I get a Coast Guard License?

IF YOU DO NOT HAVE A CURRENT LICENSE OR HAVE QUESTIONS ABOUT LICENSING, YOU ARE HIGHLY UNLIKELY TO BE A QUALIFIED CANDIDATE FOR THE KEEPER'S POSITION WITHIN THE TIME FRAME WE NEED TO HIRE.

Compensation and Housing

Compensation is a function of the level of business. Essentially, 40% of the gross is taken by the non-profit corporation for maintenance and capital improvements. The remaining 60% goes to the Keepers after subtracting the expenses of operation, principally food, beverage, gasoline, etc. In 2010-2011, the Keepers’ gross pay was about $87,000 annually, trending upward, plus about $10,000 in health insurance. Typically, keepers take 2-4 weeks of vacation. Modest housing is available on the island, but some keepers in the past have elected to live off the island during days off. We prefer the keepers live on the island full time.

Pets and Children

The job is incompatible with children, and pets are strongly discouraged, especially dogs.

Why would we want this job?

Incomparable views; meet a lot of interesting people; one of California's best-known bed and breakfast inns; hard work but pretty good pay for a young couple (or couple of any age) doing something unique; birds, marine mammals, fresh air, boats; and history. East Brother is a registered California Historic Landmark and is listed on the National Register of Historic Places.

How to apply

Download and fill out the application form. Return by emailing it to Tom Butt, President, East Brother Light Station, Inc., 117 Park Place, Richmond, CA 94801; faxing to 510/232-5325, or email to tom.butt@intres.com. Direct any burning questions to Tom Butt at the previous addresses.

East Brother Light Station Employment Application	Page 1

Butt, Tom

2012-01-27

Tom Butt