Elysian Senior Homes of Lake City Employment Application

Current Openings

We are adding additional care support to our team!

67 unit Assisted Living with Dementia Care

CARE & WELLNESS Care & Wellness – CNA preferred but will train!

Care & Wellness staff on days and evenings!

Part Time Evening Position 2:00 pm – 10:00 pm (1 position) $0.50/hour evening differential
Part Time Day Shift 6:00 am – 2:00 pm (1 position)
$1.00/hour CNA Differential!

Come join our exceptional team here!

Please Apply Online or In Person At:

480 West Grant Street
Lake City, MN 55041
651-448-8333

Elysian Senior Homes does not discriminate in hiring or employment on the basis of race, religion, national origin, sex, disability, sexual orientation, Vietnam era service, or any other basis which discrimination is prohibited by federal, state, or local laws. No question on this application is intended to secure information to be used for such discrimination.

Application

Name*
First Last
Are you 18 years of age or older?*
- Yes
- No
Present Address*
Street Address City State ZIP Code
Permanent Address*
Street Address City State ZIP Code
Phone Number*
Email Address*
Employment Questions
Position Desired*
Date Available to Work*
Salary Desired*
Are you employed?*
- No
- Yes
If so, may we contact your employer?
- No
- Yes
Have you ever applied to this company before?*
- No
- Yes
When and Where?
Are you legally eligible to work in the US?*
- No
- Yes
Referred by
- Temp Agency
- Online Advertisement
- Newspaper Advertisement
- Employee
- Other
Employee (name)
Education: High School
Name
Location
Check all the years completed.
- 1
- 2
- 3
- 4
Did you graduate?
- Yes
- No
Subjects studied
Education: College/University
Name
Location
Check all the years completed.
- 1
- 2
- 3
- 4
Did you graduate?
- Yes
- No
Subjects studied
Education: Trade School
Name
Location
Check all the years completed.
- 1
- 2
- 3
- 4
Did you graduate?
- Yes
- No
Subjects studied
Other
Name
Location
Check all the years completed.
- 1
- 2
- 3
- 4
Did you graduate?
- Yes
- No
Subjects studied
List any licenses, awards, certificates, or registrations pertinent to your application.
Employment Experience

Start with your present or last job. Attach a resume to list additional employment.
Employment 1
From Date
(mo/yr)
To Date
(mo/yr)
Employer Name
Employer Address
Street Address Address Line 2 City State ZIP Code
Employer Phone
Position
Supervisor's Name
Salary
Reason for Leaving
Employment 2
From Date
(mo/yr)
To Date
(mo/yr)
Employer Name
Employer Address
Street Address Address Line 2 City State ZIP Code
Employer Phone
Position
Supervisor's Name
Salary
Reason for Leaving
Employment 3
From Date
(mo/yr)
To Date
(mo/yr)
Employer Name
Employer Address
Street Address Address Line 2 City State ZIP Code
Employer Phone
Position
Supervisor's Name
Salary
Reason for Leaving
Reference 1
Cannot be related to you or a previous employer.
Name
First Last
Relationship & Title
Company Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Reference 2
Cannot be related to you or a previous employer.
Name
First Last
Relationship & Title
Company Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Reference 3
Cannot be related to you or a previous employer.
Name
First Last
Relationship & Title
Company Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Additional Information
Please list any other job-related information you think would be helpful to us in considering you for the position, such as any additional work experience, volunteer activities, hobbies, social activities, clubs or professional organizations (list offices held), publications, accomplishments, etc. (exclude informations indicative of race, color, religion, sex, age, marital status, national origin, disability, or veteran status.)
Upload Resume
Accepted file types: pdf, doc, docx, jpg, jpeg.
Max. file size: 50 MB.
Signature and Authorization

Acceptance of this application affords no assurance of eventual employment. If employed, you will be required to verify your ability to legally accept employment in the United States. For certain jobs, background investigations, to include contracting former employers, may be required. This application does not constitute a contract of employment. Employment and compensation can be terminated with or without notice, and with or without cause, at any time.
I have read the foregoing instructions and questions and to the best of my knowledge my answers are true and correct, I have not knowingly misrepresented or withheld any fact or circumstance that would, if disclosed, affect my application unfavorably. I understand that misinterpretation if any of the above may be cause for termination.
Name of Applicant*
Date
MM slash DD slash YYYY
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Careers

Current Openings

Application

Employment Questions

Education: High School

Education: College/University

Education: Trade School

Other

Employment Experience

Employment 1

Employment 2

Employment 3

Reference 1

Reference 2

Reference 3

Signature and Authorization

CONTACT INFORMATION

SOCIAL MEDIA

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