ULTIMATE EXPOSURE TANNING CENTERS________________



ULTIMATE EXPOSURE TANNING CENTERS___________

APPLICATION FOR EMPLOYMENT

Ultimate Exposure is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion, national origin, disability, sexual orientation, or any other basis prohibited by federal or state law. Must be 18 years or older to apply.

PERSONAL INFORMATION

Last name M.I. First name

Street address City State Zip

Home phone number Cell phone number Email address

Social Security # Referred by

Which phone number is best to contact you at? Home Cell

Are you legally eligible for employment in the U.S.? YES NO

Proof of identity and ability to work in the US will be required if hired

Have you ever been convicted of a felony? YES NO

If yes, list convictions that are a matter of public record. A conviction will not necessarily disqualify you for employment.

___________________________________________________________________________

EMPLOYMENT DESIRED

Position applied for: __________________________________ Date available: _____________

Are you applying for: Full-time Part-time

What location would you prefer? Chicago (downtown) Western suburbs

North/northwest suburbs South/southwest suburbs

Hours available: Mon: ______________ Tues: ________________ Wed: _____________

Thurs: ______________ Fri: ______________ Sat: _____________ Sun: _____________

EDUCATION

Name and Years completed Subjects Studied/ Did you graduate? Address of school Degrees received

|High School | | | |

| | | | |

| | | | |

|College | | | |

|Post College | | | |

|Trade School | | | |

EMPLOYMENT HISTORY

List your last three jobs, starting with the most recent first. A phone number with area code to contact your past supervisors MUST be listed in order to process the application. We will not proceed with the hiring process if we can not check an applicant’s employment history

1. Position: __________________________ Date of Employment: ___________________

Employer: _________________________ Address:______________________________

Supervisor: ________________________ Telephone: ____________________________

Starting pay: _____________________ Ending pay: ___________________________

Reasons for leaving:_____________________________________________________________

May we contact this employer? YES NO

2. Position: __________________________ Date of Employment:____________________

Employer: _________________________ Address: ______________________________

Supervisor: ________________________ Telephone: ____________________________

Starting pay: _____________________ Ending pay: ___________________________

Reasons for leaving:_____________________________________________________________

May we contact this employer? YES NO

3. Position: __________________________ Date of Employment:____________________

Employer: _________________________ Address: ______________________________

Supervisor: ________________________ Telephone: ____________________________

Starting pay: _____________________ Ending pay: ___________________________

Reasons for leaving:_____________________________________________________________

May we contact this employer? YES NO

I certify that the information contained in this application is true and complete to the best of my knowledge and understand that if employed, falsified statements or misrepresentation on this application shall be grounds for immediate dismissal. I authorize Ultimate Exposure to thoroughly investigate my background, references, and employment record and other matters related to my suitability for employment. I authorize persons, schools, employers to provide any relevant information regarding my current and/or previous employment and I release all persons, schools, and employers of any claims for providing such information. I understand that nothing contained in this application, or conveyed during any interview that may be granted, is intended to create an employment contract. I understand and agree that my employment is at will, which means that employment is for no specified period and I may be terminated by Ultimate Exposure or can terminate myself at any time without prior notice for any reason. All employees may be subject to periodic and random drug testing.

________________________________________________________________________________

Name of Applicant (Print)

Signature of Applicant

________________________________

Date

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