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APPLICATION FOR EMPLOYMENT An Equal Opportunity Employer
UNIVERSAL PARKING OF AMERICA, INC. is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.
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| Applicant Information |
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| Name: REQUIRED |
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| Current Address: REQUIRED |
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| City: REQUIRED |
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| State: REQUIRED |
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| Zip: REQUIRED |
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| Home Phone: REQUIRED |
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| Alternate Phone: |
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| Email Address: |
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| How were you referred to the company?: |
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| Employment Position |
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Position you are applying for:
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Are you applying for Regular Full-time work?:
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Yes No |
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Regular Part-time work?:
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Yes No |
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Temporary Work? (event, on-call):
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Yes No |
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What days are you available for work?:
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If hired, what date can you start?:
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Can you work weekends?:
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Yes No |
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Can you work evenings?:
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Yes No |
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Can you work overtime?:
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Yes No |
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Can you drive a manual transmission?:
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Yes No |
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| Personal Information |
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Have you ever applied to/worked for Universal Parking berfore?:
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Yes No |
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If yes, please explain and include dates for prior work:
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Have you ever been convicted for any violation of the law other than minor traffic violations?:
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Yes No |
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Are there any pending charges against you?:
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Yes No |
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Have you ever been discharged, asked to resign or filed by an employer?:
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Yes No |
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If you answered yes to an of the last 3 questions, please explain:
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If hired, do you have dependable transportation to and from work?:
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Yes No |
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If hired, would you be able to present evidence of your US citizenship or proof or your legal right to work in the United States?:
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Yes No |
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Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodations?:
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Yes No |
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If no, describe the functions you cannot perform:
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Do you have any experience, special skills or training that you feel we should be aware of that makes you especially suited for the position?:
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Yes No |
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If yes, explain:
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Are you willing to submit a drug test?:
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Yes No |
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Are you willing to give us permission to run a criminal background check?:
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Yes No |
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Are you willing to give us permission to run a DMV check?:
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Yes No |
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| Employment History |
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| Are you currently employed?: |
Yes No |
| May we contact you current employer?: |
Yes No |
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Below please describe past and present employment positions. Please account for all periods of unemployment (i.e. attending school full-time, stay at home parent, etc.)
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Employee One
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Employee Two
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Employee Three
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| Employee Four |
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| Employee Five |
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| Employee Six |
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| References |
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List below three references who have known you at least two (2) years. Two must be professional and one can be a personal reference.
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| Please Read and Initial Each Paragraph, Then Sign Below |
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I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
In consideration of my employment, I agree to conform to the rules, procedures and policies of Universal Parking, as they now exist or as they may be hereafter modified, implemented or eliminated, in whole or part. I understand that no representative of Universal Parking, other than the President and/or owners has the authority to enter into any agreement for any above described voluntary relationship, and any such agreement must be in writing and executed by the President and/or owners of Universal Parking. If any policy of Universal Parking is ever deemed to be contrary with the above-described voluntary relationship, the terms of the above described voluntary employment relationship shall govern.
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| Electronic signature: REQUIRED |
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| Date: |
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