Keystone Mission Job Application

Job Application

Please complete the form below to apply for a position with us.
Full Name *

First Name Middle Name Last Name
Current Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email Address *
example@example.com
Phone Number *
Please select the correct answer
Are you legally eligible for employment in the United States? *

Yes No
Are you interested in? *

Part-time Full-time Either?
Applying for Position *
Start date

Month Day Year
Date

SECTION 1

Please answer the questions below to help us evaluate your ability to function in this role.
What is your definition of a Christian? *
To you personally, who is Jesus Christ? *
Describe your conversion experience. *
During the course of your employment as opportunities arise, would you feel comfortable sharing the Gospel and what the Lord is doing in your life with the people you meet? *
Are there currently any activities or attitudes present in your life that would limit your ability to function as a missionary for Evangelical Christian Ministry? If so, please describe. *
Have you ever been under the discipline of a church or left a church under negative circumstances? *

References

Please provide name, address, phone number, and e-mail of 3 references including a current Pastor/Minister.
Reference #1 Full Name *

First Name Last Name
Reference #1 Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Reference #1 Phone Number *
Please enter a valid phone number.
Reference #1 Email
example@example.com
Reference #2 Name *

First Name Last Name
Reference #2 Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Reference #2 Phone Number *
Please enter a valid phone number.
Reference#2 Email
example@example.com
Reference #3 Name *

First Name Last Name
Reference #3 Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Reference #3 Email
example@example.com
Reference #3 Phone Number *
Please enter a valid phone number.

SECTION 2

EMPLOYMENT EXPERIENCE: Please share your work experience. List your last 3 places of employment including at least 5 years of employment experience. Start with your present or last job. You may include any job-related experience, military service assignment, and volunteer activities.
Employer #1 *
Employed from Start Date *

Month Day Year
Date
Employed from Last Date *

Month Day Year
Date
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Supervisor *

First Name Last Name
Work Performed *
Hourly Rate/Salary Starting *
Hourly Rate/Salary Final *
Reason for Leaving *
May we contact this employer for a reference? *

Yes No
Employer #2
Employed from Start Date

Month Day Year
Date
Employed from Last Date

Month Day Year
Date
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Supervisor Full Name

First Name Last Name
Work Performed
Hourly Rate/Salary Starting
Hourly Rate/Salary Final
Reason for Leaving
May we contact this employer for a reference?

Yes No
Employer #3
Employed from Start Date

Month Day Year
Date
Employed from Last Date

Month Day Year
Date
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Supervisor Full Name

First Name Last Name
Work Performed
Hourly Rate/Salary Starting
Hourly Rate/Salary Final
May we contact this employer as a reference?

Yes No
If yes, explain...
Have you ever been dismissed from employment?

Yes No

SECTION 3

Education

High School

Undergraduate
College/University

Graduate/
Professional

School Name
and Location

Years Completed
Diploma/Degree

Describe
Course of Study

Describe any specialized training, apprenticeship, skills, and extra-curricular activities:
Describe any honors you have received:
Summarize special job-related skills and qualifications acquired from employment or other experience
What do you consider to be your strengths?
What do you consider to be your weaknesses?
State any additional information you feel may be helpful to us in considering your application.
Do you speak Spanish?

SECTION 4

Complete this section only if applying for a position Program or Distribution department.
Do you have a valid Pennsylvania Driver's License?

Yes No
If so, what class?
Have you had violations or accidents in the past 3 years?

Yes No
Have you had experience driving?

15 passenger vans Forklifts Trucks (16' box, 17,000 GVW or larger)
If yes, please provide specifics:

SECTION 5

Agreement and Release. Please read the following paragraphs before you sign this application. Your signature constitutes your agreement thereto in return for the consideration of your application.
I authorize Keystone Mission (KM) and any employees or agents thereof, to make whatever inquiries they deem necessary of any person, educational institution, or organization to verify any of the information given in my application for employment and to determine my qualifications and abilities. In filing this application, I declare that my answers are true and complete. I understand that I will be dismissed if, after employment, it is learned that any of my answers on this application, or any supplement thereto, or in any pre-employment interview were false or incomplete. I agree to take any physical or other examinations, including a criminal background check, required of me by KM, whether prior to or subsequent to employment.

If I am accepted as an employee, I agree to obey all rules, regulations, policies of KM. I further agree that if I am employed and thereafter suffer personal injuries for which I may make a claim against KM, I shall submit to an examination by any doctor or doctors selected by KM as often as deemed necessary. My failure to comply with KM requirements in this respect shall constitute a waiver of my claim and abatement of any right of action thereon.

I hereby give my permission for the KM to use my photograph in connection with KM publicity or promotional purposes.

I agree that if I am given employment, I will be an employee-at-will and KM may subsequently terminate my employment at any time at its discretion.

I understand and accept that business needs may make the following schedule changes mandatory: overtime, shift work, a rotating work schedule, or a work schedule that includes Saturday and Sunday.

I acknowledge that my employment may provide me directly or indirectly with the acquisition of information of a confidential nature pertinent to the business of KM and I do hereby promise not to disclose, reveal, discuss, or advise anyone except authorized officials of KM concerning such information.

I authorize KM to supply my employment record, in whole or in part, and without disclosure to me, to any prospective employer, government agency, or other parties, with an interest that is not illegal or improper.

I understand that, if hired, I may be required to periodically submit to substance abuse testing. I further understand that such testing is a condition of employment with Keystone Mission and that I will be ineligible for employment in the event I refuse to consent to such testing or have otherwise violated the Mission’s policies regarding substance abuse.

I hereby acknowledge that I have read the above statement and understand the same.
Signature *

Clear
Date *

Month Day Year
Date

SECTION 6

The following code of beliefs must be subscribed to by all directors, staff, and volunteers. You are required to affirm this statement of faith on each anniversary date.
1. We believe in the eternally existing, personal, triune God: Father, Son, and Holy Spirit, who made all things.
2. We believe in the full Deity and manhood of Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through His shed blood, in His bodily resurrection and His ascension to the right hand of the Father where He now acts as Mediator and Advocate.
3. We believe in the present ministry of the Holy Spirit, whose indwelling in all believers enables them to live Godly lives.
4. We believe that the Holy Bible is a sufficient guide for all men, that it is the inspired Word of God through the activity of the Holy Spirit and that in holy reverence, it is our chief authority for a living; it is accepted as our final authority and practice.
5. We believe that regeneration by the Holy Spirit is absolutely essential for the salvation of lost and sinful man and that all who receive the Lord Jesus Christ by faith will experience repentance and forgiveness of their sins as they are born again as children of God.
6. We believe in the spiritual unity of believers in our Lord Jesus Christ and in the necessity of all His followers maintain good works as evidence of faith.
7. We believe that those who accept Jesus Christ as their Savior and Lord become members of the living body of Christ and thereby will seek out, join and participate in a local Church through regular worship of God, have fellowship with the brethren and give dedicated service to all mankind in a sacrificial spirit.
8. We believe that every believer and follower of the Lord Jesus Christ must be responsible for witness by deed and by word, and thereby will be involved in the evangelization of the world, personally and through missionary effort.
9. We believe in disciplined holy living for Jesus that depends upon the inspiration and power given by the Holy Spirit; results in an assurance that our life is now hidden in Jesus Christ; develop a present life of prayer, sacrificial giving and loving care for others and draws persons to Christ through godly character and light.
10. We believe in the personal return of our Lord Jesus Christ as the fulfillment and vindication of history, that all men are in need of salvation for this life and the next, and that some will know the resurrection of life and a heavenly homecoming, while others will know the final separation from God and the Hell of His lost love and providence.
I have read and agree with the Keystone Mission’s Statement of Faith.
Signature *

Clear
Date *

Month Day Year
Date
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Job Application

SECTION 1

References

SECTION 2

SECTION 3

SECTION 4

SECTION 5

SECTION 6