WHF Career Opportunities | Wisconsin Health Fund

Date: *

Name *

First

Middle

Last

Maiden Name:

Current Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Alternate Phone

Email *

How long have you resided at your current address? *

Are you at least 18 years of age? *

Yes
No

Are you completing this application yourself? *

Yes
No

Have you ever worked for Wisconsin Health Fund in the past? *

Yes
No

Positions(s) Your Applying For: *

Salary/Wage Desired: *

Date available to start: *

How many hours can you work weekly? *

Can you work nights? *

Yes
No

Educational Information

Levels of schooling (check ALL that apply): *

High School
College
Business or Trade School
Professional School

Have you ever been convicted of a crime? *

No
Yes

A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying.

Are you applying for an office work position? *

Yes
No

Professional References

Please list two professional references other than relatives or friends.

Reference 1 Name: *

Reference 1 Position: *

Reference 1 Company: *

Reference 1 relationship to you: *

Reference 1 phone number: *

Reference 2 Name: *

Reference 2 Position: *

Reference 2 Company: *

Reference 2 relationship to you: *

Reference 2 phone number: *

Additional Background & Qualifications:

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space above to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

Military Experience

Have you ever been in the armed forces? *

Yes
No

Are you a member of the National Guard? *

Yes
No

Work Experience

Please list your work experience beginning with your most recent job held. If you were self-employed, give firm name. Attach additional information when submitting this application if necessary.

Employer 1 Name:

Employer 2 Name:

Employer 3 Name:

Employer 4 Name:

Employer 5 Name:

Application Form Waiver

In exchange for the consideration of my job application by Wisconsin Health Fund (hereinafter called “the Company”), I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of the Company, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the Executive Director of the Company. Both the undersigned and the Company may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.

Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.

I understand that continued employment may be based on the successful passing of job-related physical examinations, depending on position.

I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

I further understand that my employment with the Company shall be introductory for a period of ninety (90) days, and further that at any time during the introductory period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

Signature: *

Date: *

This Company adheres to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.

Pre-Employment Inquiry Authorization Release

In connection with my application for employment, I understand and agree that background inquires may be requested by you or on your behalf that will seek information as to my character, work habits, including oral assessments of my job performance, experiences and abilities, along with reasons for termination of past employment. Furthermore, I understand and agree that you may request information from various federal, state, and other authorities.

All agencies, including public and private sources which maintain records concerning my past activities relating to my driving record, credit history, criminal record, civil matters, previous employment, educational background, and other past experiences.

I acknowledge that a telephonic facsimile or copy of this release shall be as valid as the original. This release is valid for all federal, state, county and local agencies and authorities.

The following is my complete and legal name, and all information is true and correct to the best of my knowledge.

Name: *

First

Middle

Last

Former names & timeframes (if applicable):

Current Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Current address dates (month & year): *

Previous Addresses:

List previous address(es) along with dates lived at each (month & year).

Signature: *

Date: *

Complete & Send Your Application

Attach Resume (optional):

If desired, you may attach your resume or other supporting information here. PDF or Word formats accepted (.pdf, .docx, .doc).

WHF Careers

Current Positions Available

Registered Nurse

Position:

Status:

Hours:

Location:

Department:

Reports to:

Scope:

Experience & Education Required:

The qualified candidate will be responsible for:

Supervisory Responsibilities:

Benefits

Apply Now

Educational Information

Professional References

Military Experience

Work Experience

Application Form Waiver

Pre-Employment Inquiry Authorization Release

Complete & Send Your Application