Personal Information

*Last Name:

*First Name:

*Middle Name:

*Position(s) Applying For:

*Desired Location(s):

*Address:

*City:

*State:

*Zip Code

*Mobile/Cell Phone Number:

Secondary Phone Number:

E-mail Address:

If you are under 18, and it is required, can you furnish a work permit:
 Yes No

If No, please explain:

Have you ever been employed here before?:
 Yes No

If Yes, give dates and positions:

Are you legally eligible for employment in this country?
 Yes No

Date Available to Begin Work:

*What is your desired salary range?:

*Type of employment desired:
 Full-Time Part-Time Temporary Seasonal

*Shift Availability:

If Chose Specific Times Only, give details:

Are you able to meet the attendance requirements of the position?
 Yes No

Have you ever pled “guilty” or “no contest” to, or been convicted of, a crime?:
 Yes No

If Yes, please provide date(s) and details:

Answering “Yes” to these questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation, and position applied for will be taken into account.

Driver’s License # (if driving is an essential job function):

State:

Employment History

Provide the following information for your past four (4) employers, assignments, or volunteer activities, starting with the most recent.

Employment #1

From (date):

To (date):

Employer:

Phone #:

Starting Job Title:

Final Job Title:

Address:

Immediate Supervisor and Title:

Summary of Work Performed and Job Responsibilities:

May we contact for reference?:

 Yes No Later

Reason for Leaving:

Starting Rate/Salary:

$

per:

Final Rate/Salary:

$

per:

Employment #2

From (date):

To (date):

Employer:

Phone #:

Starting Job Title:

Final Job Title:

Address:

Immediate Supervisor and Title:

Summary of Work Performed and Job Responsibilities:

May we contact for reference?:

 Yes No Later

Reason for Leaving:

Starting Rate/Salary:

$

per:

Final Rate/Salary:

$

per:

Employment #3

From (date):

To (date):

Employer:

Phone #:

Starting Job Title:

Final Job Title:

Address:

Immediate Supervisor and Title:

Summary of Work Performed and Job Responsibilities:

May we contact for reference?:

 Yes No Later

Reason for Leaving:

Starting Rate/Salary:

$

per:

Final Rate/Salary:

$

per:

Employment #4

From (date):

To (date):

Employer:

Phone #:

Starting Job Title:

Final Job Title:

Address:

Immediate Supervisor and Title:

Summary of Work Performed and Job Responsibilities:

May we contact for reference?:

 Yes No Later

Reason for Leaving:

Starting Rate/Salary:

$

per:

Final Rate/Salary:

$

per:

Prior Related Experience, Skills and Qualifications

Summarize any training, skills, licenses, and/or certificates that may qualify you as being able to perform job-related functions in this position.

Educational Background (if job related)

High School:

Number of Years Completed:

Did You Graduate?

 Yes No

Graduation year:

Course of Study:

College:

Number of Years Completed:

Did You Graduate?

Major:

Degree:

Course of Study:

Other:

Number of Years Completed:

Did You Graduate?

 Yes No

Course of Study:

References

Reference #1

Name:

Telephone:

Number of Years Known:

Reference #2

Name:

Telephone:

Number of Years Known:

Reference #3

Name:

Telephone:

Number of Years Known:

Pre–Interview Questionnaire

How did you hear about us?

Why are you interesting in joining our company?

In your opinion, what are the two most important things that our company does?

How can you make a positive difference at our company?

Do you have previous tanning salon experience?

 Yes No

Are you comfortable working in a sales environment?

 Yes No

Do you have previous retail sales experience?

 Yes No

Comfortable meeting monthly sales goals?

 Yes No

I expressly authorize the employer or its agents to contact and obtain information from all sources to verify the accuracy of all information provided by me in this application and I hereby waive any and all rights and claims I may have regarding the employer or its agents for seeking, gathering, and using such information in the employment process. I certify that the information I have provided in this employment application is accurate and has been completed to the best of my knowledge and ability. I understand that any falsification, misrepresentation or omission in my interviews or any other employment record, will be sufficient reason to deny employment and/or may be reason for future dismissal.

I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement