Emidio Vincenzo Escape Salon Job Application form

Application for Employment
Full Name *

First Name Middle Initial Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail *
Phone Number *

Area Code Phone Number
Applying for the Position of:
Available start date: *

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Do you have a valid driver's license?

Yes No
Are you authorized to work and remain in the United States?

Yes No
Were you ever discharged or forced to resign from any position?

Yes No
If Yes, Explain:
Position:
Department:
Have you served in the U.S. Armed Forces?

Yes No
If Yes, Branch:
Date Entered Active Duty:

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Date Released Active Duty:

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Have you ever been convicted of any violation of the law? (Exclude traffic violations) A conviction will not necessarily disqualify an applicant from the position sought.

Yes No
If Yes, Explain:
Education:
Are you a High School Graduate?

Yes No
High School Equivalency?

Yes No
Are you presently attending school?

Yes No
Type of Education
Name of Instiution
Field of Study
Type of Degree
Did you Graduate?

Yes No
Do you have additional education to enter?

Yes No
Additional Type of Education
Name of Instiution
Field of Study
Type of Degree
Did you Graduate?

Yes No
Professional License or Certificate, If Required
Type
Serial Number
Date Issued
Expiration Date

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Skills
List Salon, Sales, Retail, and Computer Background and Years of Experience:
Employment History

Beginning with your present or most recent experience, account for all employment during the past five (5) years. To elaborate, a supplemental sheet or resume may be attached, but cannot be substituted for a completed application.
Name of Employer:
Job Title:
Phone Number

Area Code Phone Number

Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Supervisor:
Ending Salary Per Month:
Date started

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Date ended

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Reason for Leaving:
Description of Duties:
Do you have additional employers to enter?

Yes No
Name of Employer:
Job Title:
Phone Number

Area Code Phone Number

Supervisor:
Ending Salary Per Month:
Date started

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Date ended

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Reason for Leaving:
Description of Duties:
May we contact your present employer?

Yes No
May we contact your former employers?

Yes No
Personal References
Full Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Business or Occupation
Phone Number

Area Code Phone Number
APPLICANT’S STATEMENT AND AUTHORITY TO RELEASE INFORMATION

(Required for ALL Positions)

By submitting this form, i hereby certify that the above information, to the best of my knowledge, is correct. I understand that falsifacation of this information may prevent me from being hired or lead to my dismissal if hired. I also provide consent for former employers to be contacted regarding work records.
Full Name
Phone Number

Area Code Phone Number
Date

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Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

How did you learn about this position?

School Newspaper Internet Website Walk-In
Attach Resume
Should be Empty:

Application for Employment

Education:

Professional License or Certificate, If Required

Skills

Employment History

Personal References