Last Name (required)

First Name (required)

Social Security Number

Address (required)

City (required)

State (required)

Zip (required)

Phone (required)

Alternate Phone (required)

Birth Date MM/DD/YY (required)

Are you legally entitled to work in the United States? (required)
Yes No 

Education

Highschool (required)

Highschool Address (required)

Did you graduate or obtain your G.E.D.? (required)
Yes No 

If no, please select the last grade you completed
9th Grade10th Grade11th Grade

What was your Grade Point Average?

College

Name of College (if applicable)

College Address?

Did you graduate from college?
Yes No 

If yes, what degree did you obtain?
(hold CTRL or CMD to select multiple)
Associates DegreeBachelors DegreeMasters DegreeOther

If no, how many hours have you completed?

Major?

Minor?

If you are currently attending, when is your scheduled
date of graduation? (MM/DD/YY )

Please list any other Education

Experience

Please list all present and past employers,
beginning with your most recent.

Employer

Employer address

What type of business was this?
(e.g. hair salon, grocery store, etc.)?

What was your job title?

What was your supervisors name?

Date Started? MM/DD/YY

Date Resigned? MM/DD/YY
(Please type "Present Employer" if you are still employed)

Starting Salary *Please indicated hourly/annually*
(e.g. $10/hour)

Last Salary *Please indicated hourly/annually*
(e.g. $10/hour)

Please enter a reference for this job

Reference phone number

Do you give Ultra Tan Louisville permission to contact
this employer?
 Yes No

If you selected no, please explain why.

Employer

Employer address

What type of business was this
(e.g. hair salon, grocery store, etc.)?

What was your job title?

What was your supervisors name?

Date Started? MM/DD/YY

Date Resigned? MM/DD/YY
(Please type "Present Employer" if you are still employed)

Starting Salary *Please indicated hourly/annually*
(e.g. $10/hour)

Last Salary *Please indicated hourly/annually*
(e.g. $10/hour)

Please enter a reference for this job

Reference phone number

Do you give Ultra Tan Louisville permission to contact
this employer?
 Yes No

If you selected no, please explain why.

Employer

Employer address

What type of business was this
(e.g. hair salon, grocery store, etc.)?

What was your job title?

What was your supervisors name?

Date Started? MM/DD/YY

Date Resigned? MM/DD/YY
(Please type "Present Employer" if you are still employed)

Starting Salary *Please indicated hourly/annually*
(e.g. $10/hour)

Last Salary *Please indicated hourly/annually*
(e.g. $10/hour)

Please enter a reference for this job

Reference phone number

Do you give Ultra Tan Louisville permission to contact
this employer?
 Yes No

If you selected no, please explain why.

Availability

Which of these times are you available to work?
(Please select all that apply, hold CTRL or CMD to select multiple)
DaysNightsWeekends

Are there any hours or days that you are unable to work?
Yes No 

If you selected Yes to the previous question, please explain.

Preferred Location(s) to work
(Please select all that apply, hold CTRL or CMD to select multiple)
Westport Plaza, 9457 Westport Rd, Louisville, KY 40241Stonybrook Shopping Center, 9038 Taylorsville Rd, Louisville, KY 40299Dorsey Plaza, 10302 Shelbyville Rd, Louisville, KY 40223Tymberwood Shopping Center,4247 Outer Loop, Louisville, KY 40219Shops of Forest Springs, 12472 LaGrange Rd, Louisville, KY 40245Woodlawn Shopping Center, 291 N. Hubbards Ln, Louisville, KY 40207

In the following space, please describe briefly why you are applying for this position:

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