SouthEnd Salon & Spa Application

SouthEnd Salon & Spa Application
5611 South Blvd
Charlotte, NC 28217
704-529-1939
Deposit: First Week Fee/ 50

SingleDoubleOther
Location

CharlotteAtlanta
Name of Applicant:

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Drivers License
Social Security # (Last 4 digits)
Cosmetologist License #
E-mail
example@example.com
Present/Former Employer
How long employed?: Minimum of 5 years in the industry
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Person/Reference:
Total number of years as a Cosmetologist/Beauty Professional:
Have you ever been convicted of a felony?

YesNo
If yes, what/when?
Applicant herby represents that all of the above statements and information furnished are correct and authorizes verification of such
Projected move-in date:

MonthDayYear
Print Name
Signature:
Date

MonthDayYear
Should be Empty: