Application

Peters & Keatts Equipment is an equal employment opportunity employer which selects the individual who is the best match for a position based on job-related qualifications, without regard to race, color, creed, sex, national origin, religion, sexual preference, age, disability, or other protected group status. Like substantially all American employers, Peters & Keatts employs its personnel "at will". This means that you are free to leave your employment with Peters & Keatts at any time, and Peters & Keatts is free to terminate your employment at any time. The period upon which compensation is based, e.g. hourly, monthly, annually, does not modify an employee's at will status. Peters & Keatts requires all new employees to pass an initial drug screening prior to employment. If you would like to request a reasonable accommodation or other assistance completing this form, please email Brian@petersandkeatts.com or call (208) 743-0866.

First Name*

Last Name*

Email*

Phone*

Address*

City*

State*

Zip*

Position(s) Applied For*

Are you over 18 years of age?*

Yes

Have you filed an application here before?*

Yes

Have you ever been employed here before?*

Yes

Are you employed now?*

Yes

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status? (Proof of citizenship or immigration status may be required upon employment)*

Yes

On what date would you be available for work? **

Are you available to work*

Are you on a lay-off and subject to recall?*

Yes

Are you able to perform the essential functions of the position you are applying for with or without a reasonable accommodation?*

Yes

Do you hold a Commercial Driver License (CDL)?*

Yes

REFERENCES

Please give the name, email and/or telephone number, and relationship of three references who are not related to you.

Name 1*

Relationship to Reference 1*

Phone 1*

Email 1*

Name 2*

Relationship to Reference 2*

Phone 2*

Email 2*

Name 3*

Relationship to Reference 3*

Phone 3*

Email 3*

HEAVY LIFTING ACKNOWLEDGMENT

All positions require heavy lifting, strenuous physical labor and potentially long work hours. Employees must be able to continuously lift items 50 pounds or more on a daily basis. I acknowledge that I am physically able to do the work and perform all job duties with or without a reasonable accommodation. By typing in your name in the signature area it is considered your signature and therefore you agree to the terms and conditions.*

SPECIAL EMPLOYMENT NOTICE FOR VETERANS

Government contractors are subject to 38 USC 4012 of the Vietnam Era Veterans Readjustment Act of 1974 which requires that they take affirmative action to employ and advance in employment qualified disabled veterans and veterans of the Vietnam Era, and Section 503 of the Rehabilitation Act of 1973, as amended, which requires government contractors to take affirmative action to employ and advance in employment qualified handicapped individuals.

If you are a disabled veteran, or have a physical or mental handicap, you are invited to volunteer this information. The purpose is to provide information regarding proper placement and appropriate accommodation to enable you to perform the job to the best of your ability in a proper and safe manner. This information will be treated as confidential. Failure to provide this information will not jeopardize or adversely affect your consideration for employment. If you wish to be identified, please sign below. By typing in your name in the signature area it is considered your signature and therefore you agree to the terms and conditions.

Choose

Disabled veteran

Recently separated veteran

Active duty campaign or wartime veteran

Campaign badge veteran

Armed Forces service medal veteran

EMPLOYMENT EXPERIENCE

Start with your present or last job. Include military service assignments and volunteer activities. Exclude organization names which indicate color, religion, sex, or national origin. If you are applying for a position in the Sprague, WA area you are not required to disclose hourly rate/salary information.

Previous Job Title

Date Previous Job Started

Date Previous Job Ended

Previous Job Description

Reason for Leaving

Special Skills and Qualifications

EDUCATION

High School Name:

Years Completed

Graduated?

Yes

GED?

Yes

Describe any Specialized Training, Apprenticeship, Skills, and Extra-Curricular Activities:

Honors Received:

State any additional information you feel may be helpful to us in considering your application:

APPLICANT'S STATEMENT

I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the investigation of all statements in this application for employment as may be necessary in arriving at an employment decision and Peters and Keatts from any and all liability concerning collection and use of information. I understand that this application is not and is not intended to be a contract of employment. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the company. By typing in your name in the signature area it is considered your signature and therefore you agree to the terms and conditions.*

Application For Employment

REFERENCES

HEAVY LIFTING ACKNOWLEDGMENT

SPECIAL EMPLOYMENT NOTICE FOR VETERANS

EMPLOYMENT EXPERIENCE

EDUCATION

APPLICANT'S STATEMENT

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