Aspen Acres

Hayward, WI Memory Care and Assisted Living

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Call 715-634-5700

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Employment – Apply Now

Employment

Aspen Acres Assisted Living, LLC is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status.

To apply for employment, please complete the form below.

Date
MM slash DD slash YYYY
PERSONAL
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Cell Phone
Home Phone
Position Desired
Available to Start
When would you be available to begin work?
Shift Availability
This position requires both day, night, and weekend shifts. Would you be available to work these shifts (with flexibility)?
- Yes
- No
Shift Availability Notes
Legally Eligible for Employment?
Are you legally eligible for employment in the United States?
- Yes
- No
* If offered employment, you will be required to provide documentation to verify eligibility.
Driver's License
Do you have a valid driver's license?
- Yes
- No
EDUCATION
Education
Please indicate highest level of education and any additional training(s):
EMPLOYMENT
List most current employer first, including U.S. Military Service.
Employer
Position
Dates of Employment - From
Employed From:
Dates of Employment - To
To:
Hours Worked Per Week
Hours Worked Per Week
Salary
Full or Part Time
- Full Time
- Part Time
Duties
Supervisor
Telephone
Reason for Leaving
May We Contact
May we contact this employer?
- Yes
- No
Employer
Position
Dates of Employment - From
Employed From:
Dates of Employment - To
To:
Hours Worked Per Week
Hours Worked Per Week
Salary
Full or Part Time
- Full Time
- Part Time
Duties
Supervisor
Telephone
May We Contact
May we contact this employer?
- Yes
- No
Employer
Position
Dates of Employment - From
Employed From:
Dates of Employment - To
To:
Hours Worked Per Week
Hours Worked Per Week
Salary
Full or Part Time
- Full Time
- Part Time
Duties
Supervisor
Telephone
May We Contact
May we contact this employer?
- Yes
- No
REFERENCES
Give the names of three people not related to you.
REFERENCES: Name
Company
Address
Phone
Email
Relationship
Years Acquainted
REFERENCES: Name
Company
Address
Phone
Email
Relationship
Years Acquainted
REFERENCES: Name
Company
Address
Phone
Email
Relationship
Years Acquainted
Were You Referred by Someone?

REFERRAL
May we thank anyone for referring you to us?
- Yes
- No
Referred By
RECORD OF CONVICTION
Record of Conviction
Were you ever convicted of a crime other than a traffic offense?
- Yes
- No
Conviction Details
This application for employment will be kept on file for one year. Consideration for employment after this year requires a new application.

APPLICANT’S CERTIFICATION AND AGREEMENT

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Aspen Acres Assisted Living, LLC and Aspen Communities, LLC to verify accuracy. I hereby release Aspen Acres Assisted Living, LLC and Aspen Communities, LLC from result of obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules, and regulations of employment of Aspen Acres Assisted Living, LLC and Aspen Communities, LLC. However, I further understand that neither the policies, rules, and regulations of employment or anything said during the interview process shall be deemed to constitute the terms of offer for an indefinite duration and at will and that either I or Aspen Acres Assisted Living, LLC or Aspen Communities, LLC may terminate my employment at any time with or without notice or cause.
Signature
Please sign by typing your full name:
Date
Today's date:
MM slash DD slash YYYY
AUTHORIZATION FOR RELEASE OF INFORMATION
(for official use only; not to be released to unauthorized persons)
Name
I, the above signed, hereby empower an employee of Aspen Acres Assisted Living, LLC or Aspen Communities, LLC to obtain information, documents and/or records pertaining to me from any and all of the following sources:

1. Department of Health Services Background Information Disclosure
2. Municipal, State or Federal law enforcement agencies
3. Civil or Criminal Courts or any repository maintaining arrest or conviction records
4. Selective Service System
5. Military Service
6. Any banking institution
7. Any place of business (for purposes of obtaining credit or employment data)
8. Credit rating bureaus or institutions maintaining individual credit rating files
9. Any previous employer
10. Present employer
11. Any school, college, university or other
12. Persons who may serve as character references
13. Any social media or networking site

I hereby release any Municipal, State or Federal law enforcement agency, individual or institution, including its officers, employees or related personnel, both individually and collectively, from any and all liability for damages of whatever kind which may at any time result to me, my heirs, family or associates because of compliance with this authorization and request to release information or any attempt to comply with it.

Exceptions to this blanket authorization

1. Any medical information in the possession of any source named above unless the request is subsequent to a conditional offer of employment as per the Americans with Disabilities Act.
Additional Exceptions
Additional Exceptions
This authorization is valid for one year from the date listed below. (Birth date is required for Department of Health Services Background Information Disclosure.)
Signature
Digital signature
Date
Today's date
Birth date
Birth date
Address
Street Address Address Line 2 City State ZIP Code
Comments
This field is for validation purposes and should be left unchanged.

Let’s Start Talking

Call 715-634-5700 for more information or to schedule a tour.

Contact Information

10214 Rock Creek Road
PO Box 1390
Hayward, WI 54843
Phone: 715-634-5700
Email: Admin@AspenAcres.org

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