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Custom Apparel Order Form

Please fill out the details for your apparel order below.

First name

Last name

Email address

Delivery Address

Country/Region

Address

City

Zip / Postal code

Date of Birth

What is your status in the U.S

Are you legally authorized to work in the United States?

Are you authorized to work on U.S federal contracts requiring background investigation?

Maximum Deployment Length

Are you available to deploy within 24-72 hours

Do you have reliable transportation?

Are you willing to Travel to disaster zones

other machinery experience

other certifications

Can you lift 50+ pounds?

Can you work outdoors/harsh conditions for long hours?

Previous Disaster Experience Relevant Professional Experience (Past 10 Years Required) Include federal, contractor, military, or technical experience. No expeirence will not hurt the hiring process; heros are needed.

Employer

Employment Dates (Month/Year-Month/Year)

Please describe your applicable skills pertaining to this position

Race

Gender

We are a federal contractor subject to Section 503 of the Rehabilitation Act. We invite applicants to self-identify whether they have a disability. Providing this information is voluntary and refusal will not stop potential job placement

Ethnicity

Voluntary Self-Identification of Protected Veteran Status

Applicants must be legally authorized to work in the United States. If selected for employment, you will be required to complete Form I-9 and the E-Verify employment eligibility verification process prior to deployment.

Holt & Worthy Federal Services

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Field Service Technician

Custom Apparel Order Form

Previous Disaster Experience Relevant Professional Experience (Past 10 Years Required) Include federal, contractor, military, or technical experience. No expeirence will not hurt the hiring process; heros are needed.