Courage MKE Application for Employment
Email *
What Position are you applying for *
Name (First, M.I and Last) *
Date of Birth *
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Pronouns *
Social Security Number *
Address (Street Number, City, State, Zip) *
Phone Number (XXX) XXX-XXXX *
Are you willing to submit to a background check? *
Available Start Date *
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Desired Pay *
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 *
Education - Please tell us the school name, Location, years attended, Area(s) studied and if you received a degree
Please tell us about any other relevant training you have.
Are you CPR Certified?
Clear selection
Are you First Aid certified?
Clear selection
Employment History - Please Provide the following: Employer Name, Supervisor's Name, Position, Phone Number, Dates of Employment, Starting Pay, Ending Pay *
Employment History - Please Provide the following: Employer Name, Supervisor's Name, Position, Phone Number, Dates of Employment, Starting Pay, Ending Pay *
Employment History - Please Provide the following: Employer Name, Supervisor's Name, Position, Phone Number, Dates of Employment, Starting Pay, Ending Pay
Please provide the name, address, phone number and email address of three references.
Why do you want to work for Courage MKE? Please attach a separate document if more space is needed.
What strengths do you bring to Courage MKE? Please attach a separate document if more space is needed.
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.
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.
Clear selection
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.
For Office Use Only: Date of Hire
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