Skip to main content
3920 N Green Bay Road
Racine, Wisconsin 53404
Phone:
(262) 639-5050
About
Our Mission
Board of Directors
Testimonials
Blog
Privacy Practices
Resources
St. Monica's 50th Anniversary Jubilee
Local Parishes
Services
Our Care
Assisted Living
Memory Care
Life Engagement
Dining
Physical Therapy
Virtual Tour & Photos
Virtual Tours
Photo Gallery
Careers
Newsletters
Contact
Contact
Volunteer
Events
1
Start
2
Complete
Date
*
Month
Month
Sep
Day
Day
3
Year
Year
2026
Position(s) Applying For:
*
Rate of Pay Expected:
*
Date Available:
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2026
2027
Would you work:
*
Full Time
Part Time
PRN (as needed)
If part time/PRN, specify days/hours:
*
Referral Source:
Referred by current employee?
*
Yes
No
Employee Name:
*
PERSONAL INFORMATION
Legal Name:
*
Format: Last First Middle
Street Address:
*
City:
*
Zip:
*
Phone Number:
*
Email:
*
Are you legally eligible for employment in the United States?
*
Have you ever applied to St. Monica’s before?
*
Yes
No
Have you ever worked for St. Monica’s before?
*
Yes
No
EDUCATION / LICENSES / CERTIFICATIONS
High School:
*
Diploma/GED:
*
Yes
No
Year:
*
College/Technical School:
*
Degree/Program:
*
Other Education/Training:
*
Licenses or Certifications, if applicable:
License/Certification Number(s):
Expiration Date(s):
EMPLOYMENT HISTORY — BEGIN WITH MOST RECENT
1. Employer:
From/To:
Phone:
Address:
Job Title:
Supervisor:
Salary/Rate:
Reason for Leaving:
May we contact this employer?
Yes
No
If no, explain:
