Personal Information

Emergency Contact Information

Position

Times available to work each day

Referral Source

Personal References

List two personal references not related to you and not employed by Urban Auto Spa

Education

Employment History #1

Most recent or current employer

Employment History #2

Military Experience

Additional Information

Please Note: Answering YES to the below questions does not automatically disqualify you for employment.

Employment Application Agreement

I certify that the answers given by me to the foregoing questions and statements are true and correct to the best of my knowledge without consequential omissions of any kind.

I agree that the Company shall not be held liable in any respect if my employment is rejected or subsequently terminated because of false statements, answers or omissions made by me in this application.

I understand that any misleading or incorrect statements may render this application void, and if employed, may lead to employment termination.

I understand that a medical examination based on the requirements of the position for which I am being considered may be required, and drug testing may be included as part of the regular pre-employment physical.

I also voluntarily and knowingly authorize the companies, schools or persons named above to give any information requested regarding my former employment, character and qualifications.

I hereby voluntarily and knowingly fully release and discharge, absolve, indemnify, and hold harmless said companies, schools or persons from any and all liability for any damages for issuing this information, except for the malicious and willful disclosure of derogatory facts concerning my employment made for the express purpose of preventing me from obtaining employment, which the party disclosing such facts knows to be untrue.

In consideration of my employment, I agree to conform to the rules and regulations of this organization. I understand that employment with Urban Auto Spa is at-will, meaning that my employment and compensation can be terminated with or without cause and with or without notice, at any time, at the option of either my employer or myself. While employment policies or procedures may change from time to time, only a written agreement signed by the company's president can change the employee's at-will status.