APPLICATION FOR EMPLOYMENT

Date:   

PERSONAL INFORMATION:
First Name:            Middle Initial:            Last Name:   

Phone #:            Alt. Phone #:   

Current Address:   

City:            State:            Zip Code:   

Permanent Address (If Different):   

City:            State:            Zip Code:   

Email Address:   

EMPLOYMENT DESIRED:
Desired Position:   

Desired Store Location:    Salt Lake City, UT

Date You Can Start:            Salary Desired:   

Are You Currently Employed?        Yes        No

If Employed, May We Inquire Of Your Present Employer?        Yes        No

Have You Ever Applied To Upper Limit Before?        Yes        No

EDUCATION:
High School Name:            Location:   
            Years Attended:            Did You Graduate?    Yes        No        Subjects Studied:   

College Name:            Location:   
             Years Attended:            Did You Graduate?    Yes        No        Subjects Studied:   

Trade, Business, or Correspondence School Name:     
             Location:   
             Years Attended:            Did You Graduate?    Yes        No        Subjects Studied:   

GENERAL INFORMATION:
Subjects of Special Study/Research Work or Special Training/Skills:

U.S. Military or Naval Service:        Yes:        No:            Rank:   

FORMER EMPLOYERS:
Please List Last Four Employers, Starting with the Most Resent:

Employer #1
Date Employed (Month and Year):   From:     To:
Name of Employer:       
Address of Employer:   
Salary:        Position:       Reason for Leaving: 

Employer #2
Date Employed (Month and Year):   From:     To:
Name of Employer:       
Address of Employer:   
Salary:        Position:       Reason for Leaving: 

Employer #3
Date Employed (Month and Year):   From:     To:
Name of Employer:       
Address of Employer:   
Salary:        Position:       Reason for Leaving: 

Employer #4
Date Employed (Month and Year):   From:     To:
Name of Employer:       
Address of Employer:   
Salary:        Position:       Reason for Leaving: 

WORK REFERENCES:
Please List only individuals that you have worked with:

Reference #1
Name:            Phone Number:   
     Business:            Years Known:    

Reference #2
Name:            Phone Number:   
     Business:            Years Known:    

Reference #3
Name:            Phone Number:   
     Business:            Years Known:    

ADDITIONAL INFORMATION:
Any Additional Remarks (Optional):

AUTHORIZATION:
    By clicking the "SUBMIT" Button, "I certify that the facts contained in the application are true and complete to the best of my knowledge and understand that if employed, falsified statements on the application shall be grounds for dismissal.
    I Authorize investigation of all statements, contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
    I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.

Thank you for applying with UPPER LIMIT FITNESS!
An Equal Opportunity Employer.