Application for Employment

  • All information obtained within this application will be held in strict confidence, subject to applicable law
  • Please complete all applicable sections and sign (check box) 

Key Tech Communication Call Centers, Inc., Key Tech Communication Services, LLC and Answer-Med, a division of Key Tech Communication Services, LLC prides itself on being an Equal Opportunity Employer.  We will not discriminate in employment because of sex, age, race, physical disability, religion, mental disability, martial status, ancestry, or place of origin.
1.
Date:
Name:
Address:
Telephone:
Date of Birth:
Social Security #:
Are you legally entitled to work in USA? 
Positions applied for:
Date you are available for employment:
Wage or salary desired:
Have you ever worked for any of the Key Tech Companies before?
2.   EDUCATIONAL BACKGROUND

Key Tech has a company policy stating a minimum educational level of Grade 122 or equivalent for all positions.

Highest level of education completed:
Name of educational institute:
What machines or equipment have you operated which relates to the position you have applied for:
Are there any skills, experience, or other qualifications which you feel would assist you in performing the duties of the position you have applies for?
3a.  PAST EMPLOYMENT

List below your last three employers, starting with the most recent.

Employer  Name:
Commencement Date:
Departure Date:
Reasons for Departure:
Supervisor's Name:
Telephone:
Position's) Held:
Duties:
May we contact this employer? (If not, state brief reason):
3b.  PAST EMPLOYMENT

List below your last three employers, starting with the most recent.

Employer  Name:
Commencement Date:
Departure Date:
Reasons for Departure:
Supervisor's Name:
Telephone:
Position's) Held:
Duties:
May we contact this employer? (If not, state brief reason):
3c.  PAST EMPLOYMENT

List below your last three employers, starting with the most recent.

Employer  Name:
Commencement Date:
Departure Date:
Reasons for Departure:
Supervisor's Name:
Telephone:
Position's) Held:
Duties:
May we contact this employer? (If not, state brief reason):
4.  

If you are applying for a position that requires driving, please complete this section:  

Note: If you are selected for an interview, you are required to present a copy of your driving record that is note more than 4 weeks old.  After being hired, a copy of this record will be placed into your personnel file and an annual update will be required.

Do you have a valid drivers license?
License #:
5.

False information given or implied on an application is grounds for immediate dismissal without further notice.

I hereby state that all information provided is accurate and may be verified by you.  I agree that I may be discharged if Key Tech, at any time, learns of falsification or material omission in the information provided on this application form and related documents.  Key Tech may contact my former employer in connection with the consideration of my employment with them.  All references are hereby authorized to release all information which they may have relevant to my employment with them.  I hereby release Key Tech its affiliates, successors, and assigns, and all references from any liability that might be claimed because of information provided by such references.

I agree that I will follow all Company policies, rules, procedures, and all other directions pertaining to my employment.  I understand that Key Tech reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at any time.

Applicant Signature (Type Name):
Date:
NO CONSIDERATION OF EMPLOYMENT WILL BE GIVEN TO ANY APPLICANT WHO DOES NOT SIGN THE ABOVE STATEMENT.  YOUR TYPED NAME IS SUBMISSION OF YOUR SIGNATURE.

NOTE: Additional personal information will be required to complete benefit forms after being hired.

THANK YOU FOR SHOWING INTEREST IN PURSUING A CAREER WITH THE KEY TECH COMMUNICATION COMPANIES.

                           

  Key Tech Communication Services, LLC

1-800-734-0761
400 Hart Street, Monroe, LA  71201