For Staff • Contact Us
Dove Healthcare - Bloomer
Dove Healthcare - Osseo
Dove Healthcare - West Eau Claire
Dove Healthcare - Wissota Health & Regional Vent Center (Chippewa Falls)
All registrations must be received by midnight on the Thursday before the class begins.
February 17 - March 23 (Day) M,T,W from 7am-3:30pm
June 1 - 25 (Day) M,T,Th,F from 7am - 3:30pm
January 6 - 24 (Day) M-F from 7am - 3:30pm (This class is full, but you can still apply and be added to our wait list.)
February 3 - 27 (Day) M,T,Th,F from 6am - 2:30pm
February 3 - March 13 (Evening) T,W,Th,F from 4pm - 9pm
March 9 - April 2 (Day) M,T,Th,F from 7am - 3:30pm
April 6 - May 15 (Evening) M,T,Th,F from 4pm - 9pm
January 6 - February 10 (Day) M,T,W from 7am-3:30pm
March 30 - May 4 (Evening) M,T,W,F from 3pm-9:30pm (This class is full, but you can still apply and be added to our wait list.)
First Name:
Middle Inital:
Last Name:
Primary Phone:
Secondary Phone:
Address:
City:
State: Wisconsin --------------- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:
Email:
Please check one of the following:
I am interested in participating in Dove Healthcare's Train-to-Work Program, a no-cost option for the CNA class and state competency exam. This program requires an interview and 12 month work commitment as a CNA with Dove Healthcare.
I am not interested in the Train-to-Work Program and will be using my own funds or 3rd party funds to pay the class fee and state competency exam.
At which facility would you prefer to work?
Dove Healthcare - Barron
Dove Healthcare - Orchard Hills Assisted Living (Eau Claire)
Dove Healthcare - Rice Lake
Dove Healthcare - Rutledge Home (Chippewa Falls)
Dove Healthcare - South Eau Claire (Mall Drive)
Dove Healthcare - West Eau Claire (Truax Blvd)
Where did you hear about this class? Please select one: CNA Class at Dove Healthcare Clinical Student at Dove Healthcare Craigslist Dove Healthcare Employee Email from Dove Healthcare Facebook Glassdoor Google Ad / Post HandShake Indeed.com Instagram Job Center / Workforce Resource Job Fair Letter / Postcard from Dove Healthcare LinkedIn Newspaper Online Website Parade Resident / Patient School or College Simply Hired Student Ambassador UWEC Footbridge Meet and Greet Walk-In Other
Please select one
Please specify
Add another referral source.
Are you applying to take this class in an effort to pursue an employment opportunity with Dove Healthcare? Yes No
Are you applying to take this class to satisfy a program requirement (i.e. nursing school)? Yes No
Contact Name:
Relationship:
Phone:
Name:
I verify that all the information which I have provided on this application and in resumes/exhibits is true, correct and complete. I understand that false, misleading, incomplete or omitted information will result in rejection of my application, whenever discovered. If my application is considered, I authorize an investigation and verification of all information and statements provided on this application. I release any and all persons or companies from any liability for releasing information or verifying statements on this application.
By signing and dating this form, I hereby swear all the above information is correct.
My typed first and last names below shall have the same force and effect as my written signature.
Date:
Confirmation Code:
715-720-2798
Dove Healthcare - South Eau Claire
Dove Healthcare - Orchard Hills
Dove Healthcare - Rutledge Home
Dove Healthcare - Wissota Health & Regional Vent Center