Application for SkinRX

SKINRx & HEALTH - Aesthetician Employment Application

Gray, Tennessee info@skinrxhealth.com
Full Name
Date of Birth

MonthDayYear
Date
Phone Number
Email Address
example@example.com
Address
Are you a licensed Aesthetician in the State of Tennessee?
TN Aesthetician License Number
Expiration Date of License

MonthDayYear
Date
Date Available to Start

MonthDayYear
Date
Preferred work days and times
How many years of experience do you have as an aesthetician
List services you are most confident and experienced in providing
Are you comfortable with commission-based pay in addition to an hourly rate?
Do you currently have an established clientele?
School Attended
Graduation Date

MonthDayYear
Date
Additional Certifications eg laser waxing brows
Employment History - Last 3 Jobs

(Please include starting and ending wages)
Employer Name
Position Held
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Reason for Leaving
Ending pay rate
Employer Name
Position Held
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Reason for Leaving
Ending pay rate
Employer Name
Position Held
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Reason for Leaving
Ending pay rate
(Professional references only; no relatives)
Name
Relationship
Relationship
Name
Relationship
Relationship
I certify that the information provided is true and complete to the best of my knowledge.I understand that false information may disqualify me from employment or lead to termination.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: