Courage MKE Application for Employment
Email address *
What Position are you applying for *
Name (First, M.I and Last) *
Your answer
Date of Birth *
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Pronouns *
Your answer
Social Security Number *
Your answer
Address (Street Number, City, State, Zip) *
Your answer
Phone Number (XXX) XXX-XXXX *
Your answer
Email Address *
Your answer
Are you willing to submit to a background check? *
Available Start Date *
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Desired Pay *
Your answer
Availability - Please check all that apply *
Required
What shifts are you interested in - Please check all that apply *
Required
Education - Please tell us the school name, Location, years attended, Area(s) studied and if you received a degree *
Your answer
Education - Please tell us the school name, Location, years attended, Area(s) studied and if you received a degree
Your answer
Please tell us about any other relevant training you have.
Your answer
Are you CPR Certified?
Are you First Aid certified?
Employment History - Please Provide the following: Employer Name, Supervisor's Name, Position, Phone Number, Dates of Employment, Starting Pay, Ending Pay *
Your answer
Employment History - Please Provide the following: Employer Name, Supervisor's Name, Position, Phone Number, Dates of Employment, Starting Pay, Ending Pay *
Your answer
Employment History - Please Provide the following: Employer Name, Supervisor's Name, Position, Phone Number, Dates of Employment, Starting Pay, Ending Pay
Your answer
Please provide the name, address, phone number and email address of three references.
Your answer
Why do you want to work for Courage MKE? Please attach a separate document if more space is needed.
Your answer
What strengths do you bring to Courage MKE? Please attach a separate document if more space is needed.
Your answer
What challenges do you think are facing the residents of Courage? How will you respond to those? Please attach a separate document if more space is needed.
Your answer
Do you currently have any pending misdemeanor charges against you? (Note: Answering yes to this question does not disqualify you from this position) We ask this question as all names and contact information must be submitted to state and federal agencies.
By Typing my full name and last four of my social security number in the box below, I certify that the answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may lead to termination of employment.
Your answer
For Office Use Only: Date of Hire
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