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  • Employment Application Form:

  • Thank you for your interest in Kind Staffing Group! 

    As an agency our clients come to us to provide qualified, well trained staff that can jump in wherever needed. We require all employees to have a minimum of three months experience in a longterm care setting (outside of clinicals) as a CNA, LPN, or RN (DSP experience does not count as CNA experience). If you just recently passed your state exam we are so happy that you're here, but ask that you come back soon to apply!

  • Personal Information:

  • Format: (000) 000-0000.
  • Do you have at least 3 months experience in a longterm care/skilled nursing setting (outside of clinicals) as CNA, LPN, or RN? If no- your application will be saved but we will not proceed with the hiring process. Please check back after a few months! If you are a DSP please do not apply for a CNA position unless you have at least 3 months experience after certification. You must have at least 3 months of experience AFTER you passed your certification exam. If you answer yes, but it is not reflected on the state portal your application will be rejected.
  • Position location*
  • Are You a U.S. Citizen?*

  • Employment Desired:

    Select all locations that you're interested in
  • Date You Can Start*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Do you have a current CPR Certification? (You must have a current certification before we can proceed with your employment unless you are applying for a Dietary Aide or Cook position)*

  • Education:

  • Graduated?*
  • Graduated?

  • Current Employment:

  • Start Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • May We Contact?

  • Previous Employment:

  • Start Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • End Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Start Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • End Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • REFERENCES- Two professional references are required. Are you able to provide at least two professional, non-family references upon hire?*

  • Send Application:

  • By clicking the submit button below, I cerity that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employement may be terminated at any time.  

    In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compenstation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option.  

    I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.  

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