2. APPLICATION FOR EMPLOYMENT
4. Position applied for:*
5. Application Date:*
   Application Date:
7. First Name, Middle Initial
8. Last Name
10. Street Address:*
12. City*
13. State*
14. Zip Code*
16. Home Phone:*
17. Cellular/Other Phone:*
19. E-mail Address:
20. Expected Pay (Annual)*
22. Shift Preferred:*
    -- Select One --123Any
23. Type of work preferred:*
    -- Select One --Full-TimePart-TimeAny
25. Date Available to Start Work:*
    Date Available to Start Work:
26. Best time to call you?*
28. How were you referred to us?*
30. Have you submitted an application here before?*
    -- Select One --NoYes
31. If Yes, for which position(s):
32. Date(s) previously applied:
34. Have you ever been employed here?*
    -- Select One --NoYes
36. If yes, please give dates/positions:
38. Is this application a request for reemployment following an extended military leave of absence? If yes, additional information may be requested.*
    -- Select One --NoYes
39. If you are under 18 years old, can you provide a work permit if required? *
    -- Select One --N/AYesNo
41. Are you eligible for employment in the United States?*
    -- Select One --YesNo
43. Are you able to perform the "essential functions" of the job for which you are applying (with or without reasonable accommodation)? *
    -- Select One --NoYesNeed more information about the job
45. NOTE: The question above is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. This may be addressed at a later stage, to the extent permitted by law.
47. Will you travel if required?*
    -- Select One --YesNo
48. Will you work overtime if required? *
    -- Select One --YesNo
50. Can you meet the attendance requirements of the position?*
    -- Select One --YesNoNeed more information about the job
51. Have you ever been bonded?*
    -- Select One --NoYes
53. If driving is required for this job, please provide your driver's license number:
54. State Issued:
56. Have you entered into an agreement with any former employer or other party (such as a noncompetition agreement) that might, in any way restrict your ability to work for the City of Universal City?*
    -- Select One --NoYes
57. If yes, please explain:
59. NOTE: Answering "yes" to the following quesiton does not constitute an automatic bar to employment. Factors such as date of offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.
61. Have you ever pleaded "quilty" or "no contest" to, or been convicted of a crime? *
    -- Select One --NoYes
62. If yes, please explain (include date and offense):
64. Employment Experience

    Fully complete all fields that are applicable.  "SEE RESUME"  IS NOT A VALID RESPONSE.

66. Current or Most Recent Employer
68. May we contact this employer?
    -- Select One --YesNo
69. Employer Phone:
71. Company or Business Name:
73. Name of Person to Verify Employment:
75. Employer's Street Address:
77. City, State, Zip:
79. Your Job Title:
80. Your Supervisor's Name:
82. Hire Date: (mm/yy):
83. End Date (mm/yy):
85. Starting Hourly Rate or Salary:
86. Ending Hourly Rate or Salary:
88. Work Performed:
90. Reason For Leaving. If currently employed, please include reason for leaving current employment:*
92. What did you like most about your position?
94. What did you like least about your position?
96. Previous Employer #2
98. May we contact this employer?
    -- Select One --YesNo
99. Employer Phone:
101. Company or Business Name:
103. Name of Person to Verify Employment:
105. Employer's Street Address:
107. City, State, Zip:
109. Your Job Title:
110. Your Supervisor's Name:
112. HIre Date: (mm/yy):
113. End Date (mm/yy):
115. Starting Hourly Rate or Salary:
116. Ending Hourly Rate or Salary:
118. Work Performed:
120. Reason For Leaving:
122. What did you like most about your position?
124. What did you like least about your position?
126. Previous Employer #3
128. May we contact this employer?
     -- Select One --YesNo
129. Employer Phone:
131. Company or Business Name:
133. Name of Person to Verify Employment:
135. Employer's Street Address:
137. City, State, Zip:
139. Your Job Title:
140. Your Supervisor's Name:
142. Hire Date: (mm/yy):
143. End Date (mm/yy):
145. Starting Hourly Rate or Salary:
146. Ending Hourly Rate or Salary:
148. Work Performed:
150. Reason For Leaving:
152. What did you like most about your position?
154. What did you like least about your position?
156. Employment Experience Continued
158. Explain any gaps in employment other than those due to personal illness, injury or disability:*
160. Have you ever been fired or asked to resign from a job?*
     -- Select One --NoYes
161. If yes, please explain:
163. Education Background - Complete all fields that are applicable.
165. High School
167. High School Name:
169. City, State:
171. Did you graduate?
     -- Select One --YesNo
173. College
175. College Name:
176. Course of Study:
178. City, State:
180. Did you graduate?
     -- Select One --YesNo
182. Degree:
184. Graduate Studies
186. Graduate School Name:
187. Course of Study:
189. City, State:
191. Did you graduate?
     -- Select One --YesNo
193. Degree:
195. Vocational Training/Other
197. School Name:
198. Course of Study:
200. Street Address:
202. City, State, Zip:
204. Did you graduate?
     -- Select One --YesNo
206. Degree or Diploma:
208. Relevant Continuing Education:
210. Special Training or Skills
212. Languages, machine operation, software, etc., that would be of benefit in the job for which you are applying:
214. References

     List three business/work references who are not related to you and are not previous supervisors.  If business/work references are not applicable, list three school or personal references who are not related to you.

216. Reference #1
218. Name*
219. Relationship to you:*
221. Phone:*
222. Years Known:*
224. Reference #2
226. Name*
227. Relationship to you:*
229. Phone:*
230. Years Known:*
232. Reference #3
234. Name*
235. Relationship to you:*
237. Phone:*
238. Years Known:*
240. Résumé
242. If you would like to attach a résumé, please do so now.
244. Applicant Statement
246. I certify that all the information submitted by me on this application is true and complete, and I understand that if any false or misleading information, omissions or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time.

     If hired, I agree to conform to the City of Universal City's rules and regulations, and I understand that the rules and/or the employee policies and procedures manual do not form a contract of employment either express or implied, and I agree that my employment and compensation can be terminated, with or without cause and with or without notice, at any time, at either my or the City of Universal City's option.

     I expressly authorize, without reservation, the City of Universal City to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application or attached résumé. I hereby waive any and all rights and claims I may have regarding the City of Universal City for seeking, gathering and using truthful information and nondefamatory information, in a lawful manner, in the employment process and all other persons, corporations, or organizations for furnishing such information about me.

     I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the City of Universal City and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

     I also understant that, if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States as required by federal immigration laws.

     City of Universal CIty does not tolerate unlawful discrimination or harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state, or local law. No question on this application is used to limit or exclude an application from employment consideration on any basis prohibited by applicable federal, state or local law.
248. Applicant's Signature:*
Leave This Blank:


250. 1. Receive an email copy of this form.
251. Email address

     This field is not part of the form submission.

252. Submit Submit and Print

* indicates a required field