Employment Application

Personal Information

First Name

Last Name

Address 1

Address 2

Country

City

State

Zip/Postal Code

Phone Number

Email Address

Referred by:

Position or type of work desired:

Availability:
Full-time
Part-time
Temporary

Have you been employed by Keystone Church before?
Yes
No

Where do you attend church?

Tell us about where you have served in your church (leadership or volunteer roles):

Have you ever been convicted of a crime other than a minor traffic violation?
Yes
No

If YES, please explain:

Education & Experience

Please list schools you have attended with graduation dates and courses of study or majors.

Please list any additional training or experience you have that qualifies you for the position you are seeking. Please include any professional licences or certificates.

Employment History

List your last three employers, assignments, or volunteer activities starting with the most recent.

Employer:

Address:

Position:

Supervisor and Title:

Employer Phone Number:

Employment Start and End Dates:

Reason for Leaving:

Summary of Responsibilities:

Employer:

Address:

Position:

Supervisor and Title:

Employer Phone Number:

Employment Start and End Dates:

Reason for Leaving:

Summary of Responsibilities:

Employer:

Address:

Position:

Supervisor & Title:

Employer Phone Number

Employment Start & End Dates:

Reason for Leaving:

Summary of Responsibilities:

Personal References

Name:

Relationship:

Email Address:

Phone Number:

Name:

Relationship:

Email Address:

Phone Number:

Applicant's Statement

I understand and agree that any misrepresenttions by me in this application will be grounds for immediate termination if I have been employed. I give Keystone Church the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability Keystone Church and its representatives for seeking such information and all other persons, corporations, or organizations for furnishing such information. I understand that a criminal background check will be conducted on me as part of the application process and I consent to any such check. I also understand that I may be required to have a physical exam, including drug screening.

Name of Applicant (in lieu of signature):

Date:

Employment Application

Personal Information

Education & Experience

Employment History

List your last three employers, assignments, or volunteer activities starting with the most recent.

Personal References

Applicant's Statement

You may also submit a resume to jobs@keystonechurch.us

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