Apply to Work at Kearney Electric, Inc. Step 1 of 4 25% General InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Date Available for Employment* Date Format: MM slash DD slash YYYY Have you ever been employed by this company?*YesNoAre you employed now?*YesNoMay we contact your present employer?*YesNoName of Supervisor*Supervisor Phone*Type of work desired:*Do you have a valid driver's license in this state?*YesNoCan you perform the essential function of the job(s) for which you are applying?*YesNoAre you available to work:* Full Time Part Time Overtime This company is an equal opportunity employer. All applicants will be considered without regard to age, color, national origin, religion, disability, sex or other protected status in accordance with applicable Federal and State equal opportunity laws. EducationName of Elementary School:Course of Study:Years Completed: 5 6 7 8 Name of High School:Course of Study:Years Completed: 9 10 11 12 Name of College/University:Course of Study:Years Completed: 1 2 3 4 Name of Graduate School:Course of Study:Years Completed: 1 2 3 4 Special Skills, Qualifications and ConsiderationsSummarize special skills and qualifications, volunteer activities, military experience, employment or other activities related to the job you are seeking:*ReferencesList three (3) non-relatives who are familiar with your qualifications and actual work history and ability.First Reference: Name*Occupation/Relationship*Years Known*Phone*Second Reference: Name*Occupation/Relationship*Years Known*Phone*Third Reference: Name*Occupation/Relationship*Years Known*Phone* Employment ExperienceStart with your present or last job. List your last three (3) jobs in order.Employer:*Supervisor's Name:*Address:*Your Position:*Phone:*Employed from:* Date Format: MM slash DD slash YYYY Employed to:* Date Format: MM slash DD slash YYYY Starting Salary:*Ending Salary:*Duties:*What did you like most about your job?*What did you like least about your job?*Reason for leaving:* Employer:Supervisor's Name:Address:Your Position:Phone:Employed from: Date Format: MM slash DD slash YYYY Employed to: Date Format: MM slash DD slash YYYY Starting Salary:Ending Salary:Duties:What did you like most about your job?What did you like least about your job?Reason for leaving: Employer:Supervisor's Name:Address:Your Position:Phone:Employed from: Date Format: MM slash DD slash YYYY Employed to: Date Format: MM slash DD slash YYYY Starting Salary:Ending Salary:Duties:What did you like most about your job?What did you like least about your job?Reason for leaving:ALL APPLICANTS WILL BE REQUIRED TO PASS A PRE-EMPLOYMENT DRUG SCREENING TEST If requested, can you provide proof of your legal right to work in the United States?*YesNo AcknowledgementPLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED WILL BE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK THEM BEFORE SIGNING.I certify that all answers and statements I have made on this application (and resume and other supplementary materials) are true and complete without omissions. I understand that any false information will be grounds for refusal to hire or for immediate discharge if I am employed. I authorize any of the persons of organizations named in this application to give you complete information and records regarding my employment, education, character, and qualifications.*YesIf hired, I will be responsible for familiarizing myself with all rules and regulations of Kearney Electric, Inc. as they presently exist or are later modified. If hired, I recognize that my employment can be terminated, at the discretion of Kearney Electric, Inc. or at my option, without notice, at any time.*YesI also understand that no representative of Kearney Electric, Inc. has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment.*YesI understand this application is not an offer of employment and no promises or representations of employment have been made to me at this time.*YesI HAVE READ, UNDERSTAND, AND AGREE WITH THE ABOVE.Signature of Applicant*Today's Date:* Date Format: MM slash DD slash YYYY This application is valid for sixty (60) days from the date I signed. If I want to be considered for job openings more than sixty (60) days from date signed, I will submit a new application.*YesOptional Resume UploadIf you have a resume that will help us to better understand your skills and qualifications, you can upload it here.