Affordable Assisted Lifestyle Community

Employment Application

US Military Service


Type of School

Name and Location

Course of Study

# Years


Elementary & Jr. High

High School

College or University

Technical or Other

Military or Other

Employment Record

Company Name/Location


Date Start/Left

Pay Rate

Reason for Leaving

Employment Preference

Reference List

Provide information requested on three business/work or school references who are not related to you. Include name/occupation/years known and address/phone.

Upload Resume

Click "Choose File" to below to attach a copy of your resume in Microsoft Word, RTF, or PDF formats.

I certify that all information I have provided in order to apply for and secure employment with this employer is true, complete and accurate.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to cancel further consideration of this application, or immediately discharge me from employment, whenever it is discovered.

I expressly authorize the employer, its representatives, employees or agents to contact and obtain information from all references, employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of the information provided by me in this application, resume or job interview.

The application will remain current for only 90 days from the date it was submitted. At the conclusion of that time, if the applicant has not heard from the employer and wishes to be considered for employment, it would be necessary for the applicant to reapply and complete a new application form.

I understand the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing the applicant from consideration for employment on the basis prohibited by applicable local, state or federal law.

I understand that Illinois is an “at will” employment state. BMA Management, Ltd. is an “at will” employer and each employee is an “at will” employee.

“At will” employment means that you are free to leave our employment at any time for any reason you choose, and we are free to terminate that employment at any time for any reason we choose. There is no contract or agreement of any kind etween any employee and or BMA Management, Ltd. as his or her employer, requiring that you work for us for any period in the future or that we continue to employ you for any period in the future.

Neither this application nor offer of employment can or does create a contract or agreement of employment for any specified period of time.

I certify that I have read the above Applicant Acknowledgement and accept all terms.

An Equal Opportunity Employer