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Position Desired |
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Date of Application |
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Personal Information |
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First Name |
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Middle Name |
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Last Name |
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Address |
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City |
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State |
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Zip |
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Phone |
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Email Address |
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Date Available
to Begin Work |
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Full or Part Time? |
Full Time
Part Time |
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Salary Desired |
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How did you learn
about this position? |
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Desired Shifts |
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Are you over
18 years of age? |
Yes
No |
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Do you have dependable
transportation? |
Yes
No |
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Have you ever applied
for a position with us? |
Yes
No |
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If "yes," when? |
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Have you ever been
employed with us? |
Yes
No |
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If "yes," when? |
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Are you currently
employed? |
Yes
No |
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If "yes," by whom? |
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May we contact your
present employer? |
Yes
No |
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If "no," please explain? |
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If employment is offered, can you submit a birth certificate, social security card, certificate of U.S. citizenship, or verification of your legal right to work for Square One Salon in the U.S.?
Yes
No |
If employment is offered, can you produce personal identification such as a U.S. passport, a driver's license, or a photographic identification card issued by the State?
Yes
No |
Have you ever been known by another name?
Yes
No |
If "yes," identify the name(s) and relevant dates. (An affirmative response will not automatically disqualify you from being considered for employment. We need this information to perform a complete check of work and education records).
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Have you ever been dismissed or forced to resign from any employment?
Yes
No |
If "yes," please explain. (An affirmative response will not automatically disqualify you from being considered for employment).
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Have you ever been convicted of a felony, pleaded guilty or "no contest" to a felony, and/or received deferred adjudication for a felony offense?
Yes
No |
If "yes," please explain. (An affirmative response will not automatically disqualify you from being considered for employment).
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Are you able, with or without reasonable accommodation, to perform all the essential functions listed in the job description for which you are applying?
Yes
No
(A negative response will not automatically disqualify you from being considered for employment). |
If you are applying for a position involving evening or weekend work, are you available to work at those times?
Yes
No
(A negative response will not automatically disqualify you from being considered for employment). |
Are you willing to work overtime as requested?
Yes
No
(A negative response will not automatically disqualify you from being considered for employment). |
Educational Data |
High School |
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School Name |
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School City |
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School State |
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No. of Years Completed |
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Degree |
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Major Course of Study |
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College |
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School Name |
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School City |
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School State |
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No. of Years Completed |
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Degree |
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Major Course of Study |
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Graduate School |
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School Name |
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School City |
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School State |
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No. of Years Completed |
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Degree |
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Major Course of Study |
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Vocational / Special training School |
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School Name |
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School City |
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School State |
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No. of Years Completed |
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Degree |
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Major Course of Study |
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Employment History |
| In the following spaces, give a complete record of your employment, including periods of unemployment, if any. Begin with you most recent employment, and work back in time. |
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Employer 1 |
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Employer Name |
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Address |
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City |
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State |
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Zip |
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Duration |
Employed From
(Mo./Yr.) to
(Mo./Yr.) |
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Starting Position |
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Last Position |
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Other Positions Held |
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Immediate Supervisor |
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Starting Salary |
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Final Salary |
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Duties |
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Reason for Leaving |
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Employer 2 |
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Employer Name |
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Address |
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City |
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State |
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Zip |
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Duration |
Employed From
(Mo./Yr.) to
(Mo./Yr.) |
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Starting Position |
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Last Position |
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Other Positions Held |
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Immediate Supervisor |
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Starting Salary |
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Final Salary |
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Duties |
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Reason for Leaving |
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Employer 3 |
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Employer Name |
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Address |
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City |
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State |
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Zip |
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Duration |
Employed From
(Mo./Yr.) to
(Mo./Yr.) |
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Starting Position |
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Last Position |
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Other Positions Held |
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Immediate Supervisor |
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Starting Salary |
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Final Salary |
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Duties |
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Reason for Leaving |
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Special Skills or Qualifications |
Describe any other special job-related skills or qualifications (e.g., salon techniques, experience and training, computers, professional associations, licenses, etc.) that would be valuable to the position for which you are applying.
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References |
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Reference 1 |
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Name |
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Phone |
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Occupation |
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Reference 2 |
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Name |
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Phone |
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Occupation |
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Reference 3 |
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Name |
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Phone |
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Occupation |
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Applicant's Statement |
I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I also understand and agree that any falsified information or significant omissions may disqualify me from further consideration for employment, and if discovered after I am hired, may result in dismissal. I also affirm that I am making this application because I am sincerely interested in being hired by Square One Salon ("Employer") and not for any other purpose.
In consideration of my being considered for employment, I authorize a thorough investigation of my past employment and activities, agree to cooperate in such investigation, and release from liability or responsibility all persons or businesses requesting or supplying such information.
I understand and agree that if I am hired I am required to read and abide by all rules and regulation of Square One Salon governing the conduct of its employees, including the rules which prohibit the use or possession of illegal drugs, alcoholic beverages, firearms, or weapons of any kind in any office, work location, or facility of Square One Salon.
I certify that I am eligible for employment in the United States and that the documents I have furnished, or will furnish, to verify my identity and eligibility are true and correct. I further understand and agree that, if offered employment, I will have three days to submit such documents, and that failure to submit such documents within three days will result in withdrawal of the offer of employment or, if employment has begun, termination from employment.
I further understand and agree that Square One Salon may verify the information that I have given by contacting any of the reference I have provided. I hereby agree to hold Square One Salon harmless for any action it may take with respect to this application based upon the information provided to it by these references.
Please enter your full name and today's date below to indicate that you have read and agree with this statement.
Full Name
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Today's Date (mm/dd/yyyy)
*
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| This employer, in accordance with federal, state and local laws, does not discriminate on the basis of race, color, religion, national origin, sex, age disability, or any other legally protected status. Applicants may request accommodation needed to participate in the application process. This employer is an equal opportunity employer. |
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