Text Size:
Smith Senior Living - Chicago, IL
Senior living community
retirement home
Application For Employment
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

General Information
(*required field)

spam Name:
spam Subject:
*Position Applied For:
*Location Applying To:
*Application Date
How did you hear about us?
Advertising     Relative
Agency Friend
Inquiry Other
Current Employee Name:
I am currently employed by Smith communities and am interested in a new opportunity by applying for a posted job opening.
*First Name
*Last Name
Middle Initial
*Address
*City
*State        *Zip
*Home Phone
Mobile Phone
Other
*Email
*Best time to contact you at home       AM PM
*If you are under 18 years of age, can you provide required proof of your eligibility to work? Yes
No
 
*Have you ever filled out an application with us before? Yes
No
If yes, give date?
*Have you ever been employed by Smith Senior Living, Smith Village, Smith Crossing or Smith Cares? Yes
No
If yes, give date?
*Do any of your friends or relatives, other than spouse, work here? Yes
No
 
*Are you currently employed? Yes
No
 
*May we contact your present employer? Yes
No
 
*Are you prevented from lawfully becoming employed in this country because of visa or immigration status?
Proof of citizenship or immigration status will be required upon employment
Yes
No
 
*Date available for work
What is your desired salary range? to
Are you available to work Full Time Please indicate Shift
  Part Time Please indicate
  Temporary From to
*Are you currently on "lay-off" status and subject to recall? Yes
No
Can you travel if a job requires it? Yes
No
*Have you ever been convicted of a felony?
A criminal record does not constitute an automatic bar to employment and will be considered only as it relates to the job in question.
Yes
No


Education

Elementary School
Name and Address of School
Course of Study
Years Completed
Diploma/Degree
High School
Name and Address of School
Course of Study
Years Completed
Diploma/Degree
Undergraduate College
Name and Address of School
Course of Study
Years Completed
Diploma/Degree
Graduate or Professional School
Name and Address of School
Course of Study
Years Completed
Diploma/Degree
Other (Specify)
Name and Address of School
Course of Study
Years Completed
Diploma/Degree
Detail your specialized training, apprenticeship, skills and extra-curricular activities.
Describe any job-related training received in the United States military.
List professional, trade, business or civic activities and offices held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancesitry, disability or other protected status.


Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disability, or other protected areas.
1 Employer
  Address
  Telephone Number
  Job Title
  Supervisor
  *Reason for Leaving
  *Dates Employed From: to
  Hourly Rate/Salary Starting: Ending:
Work Performed
2 Employer
  Address
  Telephone Number
  Job Title
  Supervisor
  Reason for Leaving
  Dates Employed From: to
  Hourly Rate/Salary Starting: Ending:
Work Performed
3 Employer
  Address
  Telephone Number
  Job Title
  Supervisor
  Reason for Leaving
  Dates Employed From: to
  Hourly Rate/Salary Starting: Ending:
Work Performed


Additional Information

Other Qualifications
Summarize special job-related skills and qualifications acquired from employment or other experience.
Specialized Skills (Check Skills / Equipment Operated)
Microsoft Office
Word Outlook Access
Excel PowerPoint Publisher
 
Short Hand Word Processing EMR
WPM    
Equipment
Copier Fax Alcatel
Other
State any additional information you feel may be helpful in considering your application.
Note to applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE JOB REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.
Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given. Yes
No
References
1 Name
  Phone
  Address
  City
  State    Zip
 
2 Name
  Phone
  Address
  City
  State    Zip
 
3 Name
  Phone
  Address
  City
  State    Zip
*I have read and agree to the Applicant's Statement
 
Learn More:Job Application