Uforia
Dance Floor & Juice Bar
Personal Information:
Name:______________________ S.S. Number: ______-______-_____
             (please print)
Address: _____________________________________________________
            (street)                                (city)
(state)
Home Phone: __________________      Date of Birth:  ___/___/___
Position Applying For:  (check all that apply)
o Assitant Manager          o Janitorial            o Security
o Disk Jockey           o Juice Bar Attendent/      o Doorman/cashier
                                    Buser
What characteristics qualify you for this position?
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Why do you want to work for Uforia?
______________________________________________________________________________
______________________________________________________________________________
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__________
If hired how much money do you expect to be paid? _____________
Which location would you prefer to work at? (check one)
        o Medina        o Parma             o Lorain
Have you ever commited a felony?  o Yes         o No
Previous Employer: (beginning with most recent first)
Company Name: _____________________________
Address: ____________________________________________________
            (street)                            (city)
(state)
Phone #:______________________
Amt. of time employeed:     o 0-6 months  o 7 months-1 year
                            o 2 yrs-5 yrs  o 6 yrs +
Reason for leaving: _____________________________________________
____________________________________________________________
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Can we contact them?  o Yes      o No
Company Name: _____________________________
Address: ____________________________________________________
            (street)                            (city)
(state)
Phone #:______________________
Amt. of time employeed:     o 0-6 months  o 7 months-1 year
                            o 2 yrs-5 yrs  o 6 yrs +
Reason for leaving: _____________________________________________
____________________________________________________________
____________________________________________________________
Can we contact them?  o Yes      o No
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Thank you for considering Uforia as your choice of employment.
We will contact you for your interview as soon as possible.
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FOR OFFICE USE ONLY
Date and Time of interview: ________________    _______________am/pm
o Accepted          o Not Accepted
Notes: ________________________________________________________
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