Employment - Uptown Valet

State / Province / Region

Date First Available

Position Applying For

Type of Emplyment

Full Time Part Time

May we do a DMV check?

Yes No

May we do a background check

Yes No

Name of most recent school

Major and Degree Received

Reference #1: Name, Address, Phone

Reference #2: Name, Address, Phone

Reference #3: Name, Address, Phone

Employer #1: Dates of Employment

Employer #1: Starting Pay & Ending Pay

Employer #1: Reason for Leaving

Employer #1: May we contact?

Yes No

Employer #2: Dates of Employment

Employer #2: Starting Pay & Ending Pay

Employer #2: Reason for Leaving

Employer #2: May we contact?

Yes No

Employer #3: Dates of Employment

Employer #3: Starting Pay & Ending Pay

Employer #3: Reason for Leaving

Employer #3: May we contact?

Yes No

Additional comments?

Why would you like to work for Uptown Valet?

Application Submission Acceptance

I understand this application form is intended for use in evaluation of your suitability for employment. It is not an employment contract. Please answer all appropriate questions completely and to the best of your ability. False or misleading statements are grounds for refusal or termination of employment and benefits. Federal law provides penalties for false statements on documents related to US Employment eligibility. All qualified applicants will receive consideration without discrimination because race, sex, creed, national origin or the presence of non-job related disabilities, and such information may be omitted from this form. I certify that I have read and understand that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment.

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Employment With Uptown Valet

Employment Application