Keystone Job Application

Staff Application

Please review the requirements and complete the application below to apply for a position with our team. Required*
Responsibilities:
- Transporting, scheduling, and attending medical appointments with the individual.
- Transporting to and from activities as needed.
- Completing monthly paperwork.
- Maintaining a safe and clean environment for the individual.
- Assist the individual in daily living skills and individual goals.
Requirements:
- Must be 21 years of age to be a host home provider.
- Must be 18 years of age to be a day support/supported living staff member.
- Must be able to pass a background check.
- Available bedroom in your home (host home providers only).
- Must have a valid driver's license.
- Must pass a Motor Vehicle Report.
- Must complete all company trainings.
Ideal Qualifications:
- Has experience working with people with disabilities.
- Nursing/CNA background.
- Teacher/Aide background.
- Caregiver background.
Full Name*

First NameMiddle NameLast Name
Other aliases or names you have used:
Email Address*
example@example.com
Phone Number*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Social Security Number*
Select the position(s) you are applying for:*

Host Home ProviderSupported LivingDay SupportOther
Are you at least 21 years of age?*
Are you legally able to work in the United States?*
Have you ever been convicted of a crime other than a minor violation?*
If yes, please explain:
Upload a photo of the front of your driver's license

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Upload a photo of the back of your driver's license*

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Upload Resume

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Available start date*

MonthDayYear
Date
How did you hear about Keystone Residential Care?*

Employee referralSocial mediaOther
I consent to be contacted by SMS/Text for available positions.
Should be Empty:

Staff Application