DYNASTY SPA EMPLOYMENT APPLICATION

Date

Full Name*

First NameMiddle NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail

Birth Date*

MonthDayYear

Are You a U.S. Citizen?*

YesNo

Have you been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by a court??*

YesNo

if "yes" please describe in full.

Have you ever been employed by Dynasty Spas, Inc.?*

YesNo

How did yo find out about us?*

Position Applying For*

Date You Can Start*

MonthDayYear

Pay Expected*

Will you work overtime if asked?*

YesNo

High School

Name of High School Attended

Number of Years Attended

Graduated?*

YesNoGED

College

Name of College/University Attended

Number of Years Attended

Graduated?

Yes

Area of Study/Degree

Trade School/Technical

Name of Trade/Technical/Other School Attended

Number of Years Attended

Graduated?

Yes

Area of Study/Degree

Skills*

List any relevant skills

Qualifications*

List any relevant certifications or qualifications

Current Employer

Name of Current Employer or NONE if not Employed

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor Name

First NameLast Name

May We Contact?

YesNo

Supervisor Phone Number

Phone NumberExtension

Current Position

Salary

Reason for Leaving?

Start Date

MonthDayYear

Previous Employer

Name of Previous Employer

Position

Salary

Supervisor Name

First NameLast Name

Supervisor Phone Number

Phone NumberExtension

May We Contact?

YesNo

Reason for Leaving?

Start Date

MonthDayYear

End Date

MonthDayYear

I hereby consent to submit to urinalysis and / or other tests as shall be determineed by Dynasty Spas, Inc. in the selection process of applicants for employment, for the purpose of determining the drug content thereof.

I agree that Dynasty Spas, Inc. or its designated representative may collect these specimens for these tests and may test them or forward them to a testing laboratory designated by the compamy for analysis.

I further agree to and hereby authorize the release of the results of said tests to Dynasty Spas.

I undertsand the it is the current illegal use of drugs and / or abuse of alcohol that prohibits me from being employed at Dynasty Spas.

I further to hold harmless Dynasty Spas and its agents from any liability arising in whole or part out of the collection of specimens, testing, and use of the information from said testing in connection with Dynasty Spas consideration of my employment application.

I further agree that a reproduced copy of this pre-employment consent and release form shall have the same force and effect as the original.

I have carefully read the foregoing and fully understand its contents. I acknowledge that by signing of this consent and release form is a voluntary act on my part and that I have not been coerced into signing this document by anyone.

Applicant Print Name*

First NameLast Name

Date*

Date

Dynasty Spas is an Equal Opportunity Company. No applicant for employment shall be unlawfully denied employment opportunity for which he/she is qualified because of race, color, creed, gender, age, national origin or other legally protected attribute.

I understand that this application is current for 90 calendar days only for Dynasty Spas indicated on the first page. After 90 days, if I have not heard from the Employer, and still wish to be considered for employment, it will be necessary to fillout a new application.

I understand and agree that Dynasty Spas will select applicants for interview and hire on the basis of their ability, skill, knowledge and experience, which in the judgement of Dynasty Spas, best meets the overall current business needs. If I am to be hired by Dynasty Spas, the employment relationship between Employer and employee is "At Will". This phrase means that just as any employee may terminate their employment with the Employer at any time, for any reason or no reason, so may the Employer terminate an employee at any time, for any reason or no reason. The employer retains the right to terminat eemployment, with or without cause, in addition to other disciplinary action which is necessary to maintain the efficient administration of Dynasty Spas. I understand that the Employer's production requirements and customers' needs may require transfers between day and night shifts and that daily and/or weekend overtime may be obligatory. It is also agreed that the Employer has the right to determine the size of the work force and to increase or decrease the number of its employees retained; to adopt, modify, change or alter its budget; to combine or reorganize any part of, or all of its operation; to determine the location of work assignments and related work to be performed; to determine the number of employees tobe assigned to particular operations; and to determine the number of supervisors.

I also understand and agree that Dynasty Spas has the right to unilaterally modify and/or terminate any policies, practices, procedures and standards it has adopted or implemented, to the extent not limited by law. I acknowledge that no Company employee nor representative, other than its President, has either the power of authority to enter into any agreement for employment for any specified period of time, or to make any representations or agreements contrary to any of the foregoing, unless that agreement is in writing and signed by the President of Dynasty Spas. I understand that any prior representations, promises, contracts or statements made by or on behalf are expressly superseded by the foregoing.

The Immigration Reform and Control Act of 1986 states that employers must require all persons hired to submit documents to the employer showing their identity and their right to be lawfully employed in the United States. It also requires that the employee complete and sign a government form to this effect. If you are hired by the Employer, you will need to furnish documents that verify your identity and indicate that you are legally permitted to work in the United States. Documents that are acceptable include your driver's license, or state issued I.D., and your Social Security card or birth certificate. A current and valid passport is also sufficient. These documents must be provided within three (3) working days of employment. If the original documents are not available, you must submit proof that you have applied for the required documents.

I certify that all of the information furnished on this Application is true, complete and correct. I understand and agree that any falsification, misrepresentation, or omission of fact either on this Application or during the pre-hire process will bereason for (1) my not being offered employment, or (2) dismissal at any time from the service of the Company if employed.I give the Company the right to investigate all statements contained herein and the references 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 all parties from all liability for any damage that may result from furnishing same to you.

I hereby acknowledge having read and agree to the above conditions and provisions.

Applicant Print Name*

First NameLast Name

Social Security Number*

Date*

Date

Cover Letter

Upload a File

Resume

Upload a File

Application for employment:

Personal information:

Employment Desired:

Education:

Skills/Qualifications:

Current Employment:

DRUG TESTING CONSENT AND RELEASE

Authorization and Agreement

Cover Letter & Resume (Optional):