Application: Housekeeper/Server, Morningside Senior Living in Lancaster, WI Job at ElderSpan Management, LLC in Lancaster, WI; Platteville, WI

Contact phone number

Current street address

Street address (continued)

Currently in the military
or a military veteran

Yes No

Highest Rank Attained

Current (most recent) job title

Level of education attained

Current level of security clearance

Security clearance note

Legally authorized to work in the U.S.

Yes No

Available to start work

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We are glad you are considering a career at ElderSpan Management! Please answer the following questions so we can get to know you.

Q1. What is your current address?

Q2. ElderSpan Management operates senior assisted living communities throughout Southern Wisconsin. Please indicate the location(s) that you would be interested in working at.

Q3. Please tell us the times of day you are available to work.

Q4. Employment type you are looking for:

Full-Time (generally between 32 and 40 hours per week)
Half-Time (generally between 24 and 32 hours per week)
Part-Time (generally between 12 and 24 hours per week)
Casual (generally 12 hours or less per week)
Other

Q5. If you choose "Other," please explain.

Q6. What days of the week are you available to work? Check all that apply. NOTE: This position may require every other weekend.

Q7. What is your desired pay range?

Q8. When would you be available to start with us?

The following questions pertain to your employment history. Please start with your CURRENT EMPLOYER.

If you haven't had three (3) employers, type "N/A" in the fields, as they require an answer.

If you have additional experience that you would like us to consider, please attach a resume or include the information in a cover letter.

Q9. EMPLOYER 1 - Name of Company

Q10. EMPLOYER 1 - Dates of Employment (include month and year)

Q11. EMPLOYER 1 - Position or Job Held

Q12. EMPLOYER 1 - Reason for leaving

Q13. EMPLOYER 2 - Name of Company

Q14. EMPLOYER 2 - Dates of Employment (include month and year)

Q15. EMPLOYER 2 - Position or Job Held

Q16. EMPLOYER 2 - Reason for leaving

Q17. EMPLOYER 3 - Name of Company

Q18. EMPLOYER 3 - Dates of Employment (include month and year)

Q19. EMPLOYER 3 - Position or Job Held

Q20. EMPLOYER 3 - Reason for Leaving

Q21. We do not require SafeServ certification. However, if you have made the effort, we want to know about it!

I am a certified SafeServ Manager.
I am a certified SafeServ Food Handler.
I have not completed any of the SafeServ classes.

Q22. Any additional experience or information you would like us to consider?

Q23. If you have ever been discharged from employment or asked to resign, please explain.

Please provide 3 Professional References preferably from a current or former manager or supervisor. Include first and last name, email address, phone number and where you worked together.

Q24. REFERENCE 1 - Provide name, email address and phone number

Q25. REFERENCE 2 - Provide name, email address and phone number

Q26. REFERENCE 3 - Provide name, email address and phone number

Q27. How did you find out about us?

Q28. If you choose "Current Staff" or "Other," please explain.

Caring for our residents includes very important and essential functions. By applying, you agree that you are capable of and understand that this type of work requires:

- the physical ability to support up to 100 pounds, walk briskly, stand, climb stairs, sit, bend, reach, squat, push, and pull.
- the ability to read and write in English and to complete state mandated training within a required time frame.

The following information is so you get to know us better. By applying, you understand and agree:

- We support diversity and make our hiring decisions based on ability and qualifications.
- We do not tolerate harassment or discrimination.
- We can request employment, educational and legal information.
- We are an "at-will" employer.

Thank you for your interest in working with us and taking valuable time to allow us to get to know you. We will carefully review this information and contact you shortly.

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