Secured + Insured

$3 Million Dollar Insurance Policy and Full Background Check

As part of our commitment to a safe work environment we provide clients with the most comprehensive insurance money can buy. Our A+ Rated, US Based Insurance carrier protects all of our operations including all special events. Universal Parking carries General Liability, Garage Keepers Legal Liability and Workman’s Compensation insurance and provides base liability coverage of $3,000,000.00.

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.

Applicant Information

Name: REQUIRED

Current Address: REQUIRED

City: REQUIRED

State: REQUIRED

Zip: REQUIRED

Home Phone: REQUIRED

Alternate Phone:

Email Address:

How were you referred to the company?:

Employment Position

Position you are applying for:

Are you applying for Regular Full-time work?:

Yes No

Regular Part-time work?:

Yes No

Temporary Work? (event, on-call):

Yes No

What days are you available for work?:

If hired, what date can you start?:

Can you work weekends?:

Yes No

Can you work evenings?:

Yes No

Can you work overtime?:

Yes No

Can you drive a manual transmission?:

Yes No

Personal Information

Have you ever applied to/worked for Universal Parking berfore?:

Yes No

If yes, please explain and include dates for prior work:

Have you ever been convicted for any violation of the law other than minor traffic violations?:

Yes No

Are there any pending charges against you?:

Yes No

Have you ever been discharged, asked to resign or filed by an employer?:

Yes No

If you answered yes to an of the last 3 questions, please explain:

If hired, do you have dependable transportation to and from work?:

Yes No

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?:

Yes No

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodations?:

Yes No

If no, describe the functions you cannot perform:

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?:

Yes No

If yes, explain:

Are you willing to submit a drug test?:

Yes No

Are you willing to give us permission to run a criminal background check?:

Yes No

Are you willing to give us permission to run a DMV check?:

Yes No

Employment History

Are you currently employed?:

Yes No

May we contact you current employer?:

Yes No

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.)

Employee One

Name of Employer:
Name of Supervisor:
Address:
City, State and Zip:
Telephone Number:
Business Type:
Employed from:	to
Reason for Leaving:
May we contact this employer?:	Yes No

Employee Two

Name of Employer:
Name of Supervisor:
Address:
City, State and Zip:
Telephone Number:
Business Type:
Employed from:	to
Reason for Leaving:
May we contact this employer?:	Yes No

Employee Three

Name of Employer:
Name of Supervisor:
Address:
City, State and Zip:
Telephone Number:
Business Type:
Employed from:	to
Reason for Leaving:
May we contact this employer?:	Yes No

Employee Four

Name of Employer:
Name of Supervisor:
Address:
City, State and Zip:
Telephone Number:
Business Type:
Employed from:	to
Reason for Leaving:
May we contact this employer?:	Yes No

Employee Five

Name of Employer:
Name of Supervisor:
Address:
City, State and Zip:
Telephone Number:
Business Type:
Employed from:	to
Reason for Leaving:
May we contact this employer?:	Yes No

Employee Six

Name of Employer:
Name of Supervisor:
Address:
City, State and Zip:
Telephone Number:
Business Type:
Employed from:	to
Reason for Leaving:
May we contact this employer?:	Yes No

References

List below three references who have known you at least two (2) years. Two must be professional and one can be a personal reference.

References One
Name:
Address:
City, State, Zip:
How do you know this person?:
# of years known:
Telephone #:

References Two
Name:
Address:
City, State, Zip:
How do you know this person?:
# of years known:
Telephone #:

References Three
Name:
Address:
City, State, Zip:
How do you know this person?:
# of years known:
Telephone #:

Please Read and Initial Each Paragraph, Then Sign Below

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.

I understand that if I am employed, my employment is at will and can be terminated at any time either with or without prior notice, and by either me or the company.

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.

Electronic signature: REQUIRED

Date:

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