2800 Kidd Road                                          Raleigh, North Carolina 27610
             Phone (919) 231-7575                                    

at Wake Assisted Living

A career at Wake Assisted Living is a rewarding experience,
but more importantly, it is a commitment to provide the best quality
care and assistance to our residents.

If you are interested in seeking employment with
Wake Assisted Living, please fill out the form below.

Thank you!


Employment Application

All fields below must be completed in order for candidate to receive consideration for an interview.

First Name:
Last Name:
Address Street 1:
Address Street 2:
Zip Code: (5 digits)
Daytime Phone:
Evening Phone:
Position Applying For:
Experience in Long-Term Healthcare:
Full-Time or Part-Time work desired?
What shifts are you available to work?
Are you able to work weekends?
Do you have your own transportation?
Are you currently employed?
If so, why are you leaving?:
Who is your current employer?
If unemployed, who was your former employer?:
Contact Name and Phone Number of your Current or Former Employer:
Dates worked for your Current or Former Employer:
Current or Former Position Held:
Current or Former Rate of Pay:
Expected Rate of Pay:
Have you ever been convicted of a crime, felony, or serious misdemeanor?

(Please note, a conviction may not necessarily disqualify a candidate for employment. If you answered "yes" to this question, please answer the questions below.)
Nature of Crime:
  I authorize Wake Assisted Living to verify my above information.

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