Online Application for Employment

Huntington Place is committed to being Equal Opportunity Employers and that upon application to an open position all qualified candidates will be considered without regard to race, color, sex, religion, national origin, disability, veteran status, age, marital status or any other protected group status.

Applications are considered only with respect to the particular position(s) for which they are submitted and which are open at the time of application. Should you wish to be considered for another position or for a future opening in the same position, or if your application information changes, please re-apply. If you are hired, this information will become part of your employment file.

1. Personal Data

Full Name:  

Street Address
City:
State
Country:
Zip Code:
Email:
Home Phone:
Alt. Phone:
Position Appling For:
 

What are you looking for?

Full Time (30-40hrs)
Part Time (12-30hrs)
On-Call (hrs vary)
Days/hours Available

Do you have a legal right to work and remain in the United States?

Yes
No

Have you eve been convicted of a crime, including a misdemeanor?

Yes
No

Have you ever worked for Huntington Place before? If yes, please give dates and position.

Yes
No

Do you have friends or relatives at Huntington Place? If yes, please give name and relationship.

Yes
No

How were you referred to us us?

Newspaper (which one)
Job Service
Resident
Family
Huntington Place Employee (if yes, who)

 

2. Educational Background

School Name: High School or Equivalent

Location:
Years Completed:
Course of Study:
Degree(s):
 
School Name: College

Location:
Years Completed:
Course of Study:
Degree(s):
 
School Name: Business, Trade, Vocational

Location:
Years Completed:
Course of Study:
Degree(s):
 
School Name: Graduate School

Location:
Years Completed:
Course of Study:
Degree(s):
 
Occupation: Licensing or Certifications

State:
Number:
 
Line 1 Job Skills/training (pertinent to this job)

Line 2
Line 3
 

3. Work History

Please list your current and previous employers in chronological order with current employers first.  Include Military history and self employment.

Company Name: Work History #1

Company Address
City:
State
Zip Code:
Telephone #:
From / To:
Job Title:
Supervisor Name:
Final Salary:
Job Duties:

Reason for Leaving:

Resigned
Terminated
Retired
Other
Explain:

 

Company Name: Work History #2

Company Address
City:
State
Zip Code:
Telephone #:
From / To:
Job Title:
Supervisor Name:
Final Salary:
Job Duties:

Reason for Leaving:

Resigned
Terminated
Retired
Other
Explain:

 

Company Name: Work History #3

Company Address
City:
State
Zip Code:
Telephone #:
From / To:
Job Title:
Supervisor Name:
Final Salary:
Job Duties:

Reason for Leaving:

Resigned
Terminated
Retired
Other
Explain:

 

May we contact your current employer?

Yes
No, Explain:

Please explain any gaps in employment history.

Explain:

 

4. References

Huntington Place requires three reference letter from previous supervisors, co-workers, and/or teachers.  You must submit them with your application via email to jobs@huntington-place.com or you may have them faxed to 608-868-5038 attention: Manpower Coordinator.  If you prefer, you may request your references to complete our Employee Reference form.  Your application will not be considered until three references have been received.  We will contact references to verify information.

Click here to download and print Reference Check document


I understand that I must be at least 18 years of age.
I understand that I must have a High School diploma, GED or proof of working toward a GED.
I understand that Huntington Place is a no-smoking facility, including grounds and vehicles parked on Huntington Place property.

I Certify that all information in this application is accurate and complete, and understand that misrepresentation or omission of facts may result in my removal from consideration for employment or dismissal after employment.  I authorize Huntington Place personnel to investigate, without liability, all statements contained in this application and hereby release such person, corporation or other organization from any and all liability fro providing such information.  I understand that this application is not nor is it intended to be a contract of employment.  I authorize Huntington Place to contact any references provided by me

Digital Signature:

Date:

If you wish to submit a resume please email it to jobs@huntington-place.com or you may fax it to 608-868-5038 attention: Manpower Coordinator.  when emailing or faxing please reference that you filled out the online employment application.

 

3801 N. Wright Road, Janesville, WI 53546
(608) 868-5035 | mkgdir@huntington-place.com