Disclosure will not necessarily disqualify you for employment, unless the conviction is included in the exclusion for employment list as required by the
state of Wisconsin. Each conviction will be evaluated on its own merit with respect to time circumstances, and seriousness in relation to the position you
are applying for. Per Wisconsin Care Giver Background Check requirements, we perform criminal back ground checks. Falsification or omission of this or
any other information on this application is grounds for immediate termination or denial of employment. Prospective applicants / employees will need to
complete a Wisconsin Background Information Disclosure (BID)
CREDENTIALS/SPECIALIZED SKILLS & QUALIFICATIONS
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand, that, if employed, falsified statements on this application SHALL BE GROUNDS FOR DISMISSAL.
I Authorize complete investigation of all statements contained herein and herby give my full permission for the Agency to contact and fully discuss my background and history with all persons and entities listed above to give the Agency any and all information concerning my previous employment and any information they may have, and release all former employees and others listed above from all liability for any damage that my result from furnishing the same to the Agency.
I understand and agree that, if hired, my employment is for no definite period arid may, regardless of the date of payment of my wages and salary, be terminated at any time for any lawful reason, without prior notice and with or without cause.
This application for employment shall be considered active for 45 days. Any applicant wishing to be considered for employment beyond 45 days,shall inquire if applications are being accepted at that time.