Employment Application Form

1
Name:
First Name
Last Name
2
List other names you use or have used, including maiden names, nicknames, stage names, married names.
Huge
Large
Normal
Small
Ok
Ok
3
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
E-mail Address:
example@example.com
5
Phone Number:
Area Code
Phone Number
6
Best time to contact you
7
Is it OK to leave a message on either of these phone numbers?
YESNO
8
What position are you applying for?
9
Type of employment desired
Full-time
Temporary
Part-time
10
Date you will be available to start work
Date
Year
Month
Day
11
If applying for a position that requires as license, how long have you been licensed in the state of California?Please provide issuing State and Expiration Date (Skip if not applicable)
12
Are you able to meet regular attendance requirements?
YESNO
13
Do you have any objection to working overtime if necessary?
YESNO
14
If hired, can you show proof that you may legally work in the USA?
YESNO
15
How did you hear about this job opportunity?
Huge
Large
Normal
Small
Ok
Ok
16
How long have you been working as a technician in your field?
Huge
Large
Normal
Small
Ok
Ok
17
Emergency ContactName
First Name
Last Name
18
Relationship
19
Emergency Contact Phone Number
Area Code
Phone Number
20
Employment History
Please provide all employment information for the past seven years employment starting with the most recent.
21
Employer:
Position held:
Address:    Street Address     Address Line 2     City     State     Zip
Immediate Manager And Title
Dates employed from    Date    to    Date
Rate:
What percentage of your income was from tips?
Job Summary:
Reason for leaving:
May we contact this prior employer:    Yes     No
22
Employer:
Position held:
Address:    Street Address     Address Line 2     City     State     Zip
Immediate Manager And Title
Dates employed from    Date    to    Date
Rate:
What percentage of your income was from tips?
Job Summary:
Reason for leaving:
May we contact this prior employer:    Yes     No
23
Employer:
Position held:
Address:    Street Address     Address Line 2     City     State     Zip
Immediate Manager And Title
Dates employed from    Date    to    Date
Rate:
What percentage of your income was from tips?
Job Summary:
Reason for leaving:
May we contact this prior employer:    Yes     No
24
Other Skills and QualificationsDo you have other skills or qualifications that would be pertinent to the job for which you are applying? If so, please describe them in detail below:
Huge
Large
Normal
Small
Ok
Ok
25
Why are you looking to make this job change?
Huge
Large
Normal
Small
Ok
Ok
26
Educational History
High School:
College:
Cosmetology School:
Other:
27
Personal References
Please list 2 people who can comment on your qualification for the position for which you have applied:

Reference #1
First Name     Last Name        Phone Number     Email
Relationship to this person     # of years known

Reference #2
First Name     Last Name        Phone Number      Email
Relationship to this person           # of years known
28
Since reaching the age of 18, have you been convicted of a crime other that a minor traffic violation within the last 7 years? Convictions for one ounce or less of marijuana need not be reported, Conviction will not necessarily disqualify an applicant from employment
YESNO
29
If yes, please explain:
Should be Empty: