Bethany St. Joseph Corporation Employment Application Bethany St. Joseph Corporation Employment Application Thank you for your interest in working for Bethany St. Joseph Corporation! We are always looking for exceptional staff to work closely with the residents, tenants, clients, and families that we serve. Below you will find our corporation's Employment Application, which you can fill out and simply "submit" to us. If you'd rather complete a paper application, you may drop it off or mailed it into our Corporate Human Resources Office. When submitting a paper application, please address it to the following: Bethany St. Joseph Corporation Corporate Human Resources 2501 Shelby Road, La Crosse, WI 54601 If you do not have the time to complete the application, you may come back to it at a later time by clicking "Save and Continue Later". This option will send you an email link to return to this site with your partially completed application. This link will be accessible for 30 days to allow you to finish applying. At the end of the application process, we ask that you take the Affirmative Action Survey to help us meet our goals as an equal opportunity employer. NOTE: Background checks in accordance with the WI Caregiver Law, Sections 48.685 & 50.065 and Drug Testing are part of Bethany St. Joseph Corporation's hiring process. Step 1 of 3 33% About the Job...Select the facility/services that you are interested in applying for:*Bethany St. Joseph Care Center - La CrosseOnalaska Care Center - OnalaskaMarinuka Manor - GalesvilleNorseland Nursing Home - WestbyBSJ Community ServicesHold down the Ctrl key to select more then one location.For what position are you applying?*2nd Position ChoiceDate you are available to start work:* Date Format: MM slash DD slash YYYY Type of Employment desired:*Full-TimePart-TimeAs Needed/On-CallShift Preference(s)* Days PMs Nights Where did you first learn about the position opening (what brought you to the BSJ website):*BillboardCareer BuildersEmployee ReferralFacebookIndeedJob FairMonsterNewspaperRadio AdReceived an emailSchool PostingTelevision AdWalk-inWI Job Center/Workforce DevelopmentZipRecruiterBSJ WebsiteOtherList other source where you learned of positionName of person who referred youTell us about yourself...Name* First Middle Last Address* Street Address City State / Province / Region ZIP / Postal Code Phone*Email*Social Security Number (optional)Have you worked for this Corporation (currently or in the past)?*YesNoLocation*Date*Do you have a family member or committed relationship with anyone in this Corporation?*YesNoSuch as a spouse, domestic partner, child, sibling, step-parent, in-laws, etc.If yes, please identify the person, relationship, and building?* Save and Continue Later Your Education...High School Attended:Number of High School Years Completed:*OneTwoThreeFourHave you received a diploma?*YesNoG.E.D.College/Vocational SchoolSchool NameLocationMajorNumber of Years CompletedDegree Earned: You may add more than one by clicking the plus (+) sign to the right.List Professional Licenses or Certifications:TypeState IssuedRegistration #Date You may add more than one by clicking the plus (+) sign to the right.Tell us about any special training, skills, and/or military experience pertinent to the position for which you are applying:Your Employment History and References...Please provide the following information of your most recent three (3) employers and one (1) personal reference. Are you currently employed?*YesNoEmployer 1*Place of EmploymentPositionMonth/Year HiredMonth/Year EndedEnding WageDo you grant permission to contact this employer?YesNoEmployer 1 Phone NumberEmployer 1 Address Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code During the interview process, it is expected that you provide your prior employer's address and telephone number in order to conduct reference checks. By providing it now, you will not be asked to provide it in the future.Summarize Nature of Work and Job ResponsibilitiesReason for leaving Employer 1Employer 2Place of EmploymentPositionMonth/Year HiredMonth/Year EndedEnding WageDo you grant permission to contact this employer?YesNoEmployer 2 Phone NumberEmployer 2 Address Street Address City State / Province / Region ZIP / Postal Code Summarize Nature of Work and Job ResponsibilitiesReason for leaving Employer 2Employer 3Place of EmploymentPositionMonth/Year HiredMonth/Year EndedEnding WageDo you grant permission to contact this employer?YesNoEmployer 3 Phone NumberEmployer 3 Address Street Address City State / Province / Region ZIP / Postal Code Summarize Nature of Work and Job ResponsibilitiesReason for leaving Employer 3Personal ReferencePersonal Reference Name*RelationPersonal Reference Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Personal Reference Phone Number*Personal Reference Email*Resume/Cover Letter AttachmentPlease attach your resume and/or cover letter here. Drop files here or Save and Continue Later APPLICANT STATEMENT: I certify that all information I have provided in order to apply for and secure work with Bethany St. Joseph Corporation is true, complete, and correct. I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be a sufficient cause to cancel further consideration of this application, or immediately discharge me from Bethany St. Joseph Corporation, whenever discovered. I understand that Bethany St. Joseph Corporation does not unlawfully discriminate in employment and no questions on this application is used for the purpose of limiting any applicant from consideration of employment on a basis prohibited by applicable local, state, or federal law. I understand this application remains current for only 30 days. At the conclusion of that time, if I still wish to be considered for employment, it is necessary to reapply and fill out a new application. I authorize Bethany St. Joseph Corporation to contact and obtain information from all references (personal and professional), employers, educational institutions, licensing authorities, and to otherwise verify the accuracy of information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding Bethany St. Joseph Corporation for seeking, gathering, and using such information in the employment process and all other persons, corporations, or organizations for furnishing such information about me. If I am hired, I understand that I am free to resign at any time, with or without cause, and without prior notice; and that Bethany St. Joseph Corporation reserves the same right to terminate my employment at any time, with or without cause, and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no management official other than the administrator has any authority to enter into any agreement contract to the foregoing or make any oral assurance or promise of continued employment. I understand if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard. I understand that Bethany St. Joseph Corporation is a Drug-Free Workplace and I will be asked to consent to drug and/or alcohol testing as outlined in the corporation's policy. DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.* I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement. I authorize this to be my electronic signature.*Date* Date Format: MM slash DD slash YYYY CommentsThis field is for validation purposes and should be left unchanged. 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