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Application Say Grace!

Apply for a Career with Grace Lutheran Communities


3410 Sky Park Blvd., P.O. Box 287, Eau Claire, WI 54702


No question on this form is asked for the purpose of limiting or excluding any applicant’s consideration because of race, color, sex, national origin, age, marital status, creed, disability, ancestry, arrest or conviction record, sexual orientation, or status with regard to public assistance.

This application will be retained in our active file for six months. If you have not been employed within this period and are still interested in employment at Grace Lutheran Communities, please contact the office and request your application be reactivated.

A copy of the job description for the job for which you are applying, which identifies the essential functions of the job, is available upon request.

If you are offered a job with Grace Lutheran Communities (1) you may, depending on the particular job you are offered, be required to take a physical exam at the Communities’ expense, to determine if you are physically capable, with or without accommodation, of performing the essential functions of the job; and (2) you will be asked to provide your full name, sex, race and date of birth to allow the Communities to obtain information from the State Crime Information Bureau. Federal law prohibits health care facilities from hiring individuals convicted of abusing, neglecting, or mistreating other individuals in a health care or related setting. The Communities is required to make a reasonable effort to uncover information about any past criminal prosecution.

Any job offer made by Grace Lutheran Communities is contingent upon a satisfactory physical examination, if one is required, and a report from the Crime Information Bureau showing no criminal record or pending charge which substantially relates to the circumstances of the particular job offered.

Applicant Information

: May we contact you at work?
Are you 18 years of age or older?
Days available to work:
Do you have any commitments or responsibilities that might prevent you from meeting attendance requirements or that might require lengthy absence from work?
Name and relationship of relatives employed at Grace Lutheran Foundation:
Have you ever pled ”guilty”, “no contest” to, or been convicted of a crime?
Have you ever been employed by Grace Lutheran Foundation or American Lutheran Homes?
Have you ever submitted an employment application with Grace Lutheran Foundation?
Are you a citizen of the United States? If no, are you authorized to work in the US?
Are you presently employed? May we contact your present employer?


Did you graduate?
Did you graduate?
Did you graduate?
Did you graduate?
List any special skills or qualifications:


Please list three references. Do Not list former employers or relatives.

Previous Employment


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Disclaimer and Signature

Check Here to Agree.Signed by ______________________________ Date: 09/27/2020


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