Congregational Home – Founded by First Congregational Church of Wauwatosa
Employment
Benefits
Available Positions
Application Inquiry Form
 

Application Inquiry Form

*Name:
 
*Address: *City:
*State:
*Zip:
*Email Address: *Contact Phone Number:
*Are you Under 18? Yes No

*Position Interested In:
Registered Nurse Licensed Practical Nurse
Certified Medication Assistant Certified Nursing Assistant
Cook Food Service Aide
Activity Aide Housekeeper
Maintenance Receptionist
Other    
       
*Status/Shift Desired:
Full Time Part Time
First Shift Second Shift
Third Shift Any Shift
Weekend Only Days
PM’s Nights
Any Shift    

*Employment History (list most recent first):
*Company:
 *Position:
Current Rate of Pay:

*Dates employed: mm/yy
From: To:

*Reason for leaving:
   
Company:
 Position:
Current Rate of Pay:

Dates employed: mm/yy
From: To:

Reason for leaving:
   
Company:
 Position:
Current Rate of Pay:

Dates employed: mm/yy
From: To:

Reason for leaving:
 
Company:
 Position:
Current Rate of Pay:

Dates employed: mm/yy
From: To:

Reason for leaving:

*Education:
College degree Some college
Certificate Other
       

List additional skills or experience related to the job you are applying for:
 
*Have you ever been convicted of a misdemeanor (other than a minor traffic violation) or felony? (A conviction does not automatically bar you from employment.)
yes no

IMPORTANT NOTICE: Your application will be reviewed as quickly as possible. Due to the volume of applications we receive we are only able to contact those candidates we are interested in interviewing.

Please note: If you are contacted for a possible interview, you will be required to complete a Congregational Home application form, before being considered for possible hire.

* Indicates Required Field
 
         
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