APPLICANT | Keystaff

Are you willing to do a drug screen? Are you willing to release your background information? If you are not willing to then you cannot apply!

Personal

SS#*

Date of Birth*

Full Name*

First Middle Last

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone

Cellular Phone*

Email

General

Type of work desired: (please check)

I am interested in:

What is your lifting capacity?*

10lbs
25 lbs
50 lbs
100 +lbs

Can you read a tape measure?*

Yes
No

Willing to work in smoking environment?:

Drivers License Issuing State:

State

Drivers License Number:

Are you willing to take a drug test?:*

Any legal convictions?: (If yes, please explain)*

Ever been bonded?:

Availability

First Date Available:

Last Date Available:

Number of hours preferred per week:

Minimum Wage Required (per hour):*

Miles willing to travel for position?:

Willing to work overtime?:

Availability of transportation?:

Notice you require before accepting position?:

Are you a student?:

Are you on layoff/recall?:

Education

High School Name

Address

Street Address Address Line 2 City State ZIP Code

Did you Graduate?

GED?

Dates Attended

College Name

Address

Street Address Address Line 2 City State ZIP Code

Address

Street Address Address Line 2 City State ZIP Code

Degree Type

Major Studied

Dates Attended

Did you Graduate?

Past Employer (most recent first)

Company Name

Address

Street Address Address Line 2 City State ZIP Code

Phone Number

Job Title:

Start Date

End Date

Start Pay

End Pay

Pay Type

Job Description

Supervisor Name

Reason for Leaving

May we call this employer for a ref?:

Past Employer

Company Name

Address

Street Address Address Line 2 City State ZIP Code

Phone Number

Job Title:

Start Date

End Date

Start Pay

End Pay

Job Description

Pay Type

Supervisor Name

Reason for Leaving

May we call this employer for a ref?:

Untitled

Application

Personal

General

Availability

Education

Past Employer (most recent first)

Past Employer