Applicant Profile

Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Email

Confirm Email

Position Applied For *

Salary Range Considered $ to $ *

Interested In *

Shift Preference *

High School Attended | City | State *

Date Of Attendance *

Did You Graduate? *

College Attended | City | State

Date Of Attendance

Did You Graduate?

Degree Earned

Other Schooling | City | State

Date Of Attendance

Course Emphasis

Branch Of Service

Job Title

Date Of Service

Discharge? If Yes Please Explain

Special Training

Awards | Recognitions

Are You Eligible To Work In The US? *

Yes
No

Social Security Last Four Digits *

Are You 18 Or Older? *

Yes
No

Have You Ever Been Convicted Of A Felony? If Yes, Please Explain *

Do You Have Reliable Transportation? *

Reference #1 Name | Title *

Reference #1 Company | City | State *

Reference #1 Email *

Reference #1 Phone *

Reference #2 Name | Title *

Reference #2 Company | City | State *

Reference #2 Email *

Reference #2 Phone *

Reference #3 Name | Title

Reference #3 Company | City | State

Reference #3 Email

Reference #3 Phone

How Did You Learn About Keystone? *

Referral Name

Do You Know Anyone Looking For A Job?

Is It OK To Contact This Person

Referred Name | Phone | Type Of Work

Acknowledgement *

Agree

I agree to the following policies of employment. I understand and agree that if I fail to report to a new or existing job assignment without calling KeyStone Staffing Group (Keystone) at least one hour before starting time, fail to complete an assignment after having accepted it or fail to contact KeyStone after completion of an assignment, I have VOLUNTARILY QUIT my employment at KeyStone.

I understand that KeyStone may assign me to a client that requires a criminal background check, pre-employment physical and drug testing while employed. I consent to all such testing and the sharing of results with the KeyStone client.

The information provided on this application is accurate to the best of my knowledge and subject to verification by KeyStone. I understand and agree that the references obtained and letters of recommendation may be forwarded to prospective client companies. I understand that I must truthfully answer all the questions on this application. I also understand that if I do not, I may be refused employment, or separated, if I am a current employee.

KeyStone is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, sex, age, national origin, disability or any other prohibited basis.

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