This Form will only be used by the Human Resources Department and will not be forwarded to the hiring manager.
Independent Living, Inc. and Independent Health Care, Inc. have adopted an Affirmative Action Plan in compliance with State and Federal Law and City of Madison policies and ordinances. The disclosure of the following information is voluntary and allows us to meet federal, state and city government reporting requirements. This sheet will be removed from your application and the data will be treated as confidential and will not be used in making employment decisions. Refusal to provide this information will not subject you to any adverse treatment.