ApplicationforEmployment

We appreciateyourinterestinour organizationandassureyouthat we are sincerelyinterestedinyourqualifications. Aclearunderstandingofyour background andworkhistory willhelpuspotentiallyplaceyouinapositionthatmeetsyourobjectivesandthoseoftheorganization.Qualifiedapplicantsareconsideredfor allpositionswithoutregardtorace, color,religion,sex, pregnancy,nationalorigin,ancestry,age, maritalorveteran status,sexualorientation,genderidentity,or thepresenceof anon-jobrelatedmedicalconditionordisability(mentalorphysical).

PERSONAL INFORMATION / SOCIALSECURITYNUMBER / APPLICATION DATE
LASTNAMEFIRSTNAMEMIDDLE INITIAL / TELEPHONENUMBER
PRESENTADDRESSCITYSTATEZIP / REFERRED BY
ARE YOU LESSTHAN 18 YEARS OFAGE
YESNO / UPONOFFEROF EMPLOYMENT,VERIFICATIONOF YOURLEGALRIGHTTO
WORKINTHEUNITEDSTATESWILLBEREQUIRED. / HAVEYOUEVERUSEDANOTHERNAME?
YESNO
DRIVERS LICENSE NUMBERSTATEEXPIRATION DATE / DRIVING RECORD
Haveyoubeenconvictedofacrime?(Convictionswillnotnecessarilydisqualifyanapplicantfromemployment. Donotprovide
Informationaboutmisdemeanor marijuanaconvictionsmorethan two years old.)YESNO / IF “YES” PLEASE EXPLAIN:
EMPLOYMENT DESIRED / DATEAVAILABLE / SALARYDESIRED
POSITION DESIREDOR AREA OFINTEREST / HAVE YOU EVERAPPLIEDTOTHIS ORGANIZATION BEFORE?
YESNO / IF YES,GIVEDATE/POSITIONAPPLIEDFOR
HAVE YOU EVERBEEN EMPLOYED
BYOUR ORGANIZATION BEFORE?
YESNO / IF YES, GIVE DATESOF EMPLOYMENT / DO YOU HAVE RELIABLE TRANSPORTAION TO AND FROM LOCATION OF EMPOLYMENT?
CAN YOU VERIFY YOUR LEGAL RIGHT TO WORK IN THE UNITED STATES?
YESNO
CAN YOUWORK OVERTIME?
YESNO / ARE YOU CURRENTLYEMPLOYED?
YESNO / IF SO, MAYWECONTACTYOUR PRESENTEMPLOYER?
YESNO
COMMENTS
EDUCATION/U.S. MILITARYSERVICE / PLEASE INDICATE ANYLANGUAGES,OTHER THAN ENGLISHTHATYOU
SPEAK READ WRITE
SCHOOL LEVELNAME AND LOCATION OF SCHOOL / MAJOR / UNITS COMPLETEDAND
GRADE AVERAGE / DEGREESAND/OR DIPLOMAS
HIGH
SCHOOL
COLLEGE/TRADE
OTHER
PROFESSIONAL CERTIFICATES ORLICENSES HELD / ARE YOU PRESENTLYTAKINGANYEDUCATIONAL COURSE?YESNO
IF YES,WHAT ANDWHERE
HAVE YOU EVERSERVED INTHE U.S.ARMED SERVICES?
YESNO / IF YES, MILITARYDUTIES ANDTRAINING
PLEASELISTJOB RELATED ORGANIZATIONS,CLUBS, PROFESSIONAL SOCIETIES,OR OTHER ASSOCIATIONSTOWHICH YOU BELONG:
REFERENCES /
Pleaseprovideatleast3references(i.e.,formeremployers,landlords,orclients). DoNOTgivearelativeasareference
NAME AND ADDRESS / TELEPHONE / ASSOCIATION / YEARS KNOWN
1.
2.
3.
EMERGENCYINFORMATION / IN CASE OFEMERGENCY, NOTIFY
NAME / TELEPHONENUMBER
ADDRESSCITYSTATEZIP

Application for Employment–Page 2

Doyouhaveprofessional Yes No Type/Company:______

Liability / Malpractice Insurance:

Insurance / MalpracticeNumberStateExpiration


Doyouhaveaprofessionallicense:YesNo Type:

(Cosmetology,Esthetician,Massage,Manicurist,Acupuncture, Medical,etc.)

ProfessionalLicenseNumberStateExpiration


Pleaseputacheckmarknextto theareas inwhichyouarelicensed, qualifiedand competenttowork:

Microdermabrasion / Facials & Skin Care / Massage Therapy / HairStyling/Coloring / Basic Waxing
Chemical Peels
Manicures / Spray Tanning
Pedicures / Body Treatments/Scrubs
FacialSkinCare / Brow/Lash Tinting
Acupuncture / Brazilian Waxing
Electrolysis

PermanentMakeupMakeupApplicationAHA PeelsOther:

Whatequipmentdoyouown,ifany,toperformyourwork:

Whatproductlines are you proficient:

Areyouabletoprovideamodelfordemonstrationofyourabilities:YesNo

EDUCATIONand TRAINING

Pleasesharewithusanyadditionaltrainingor certificationsyouhaveearned:

Nameof School/ ProgramCityStateDateComplete

Nameof School/ ProgramCityStateDateCompleted

Nameof School/ ProgramCityStateDateCompleted

BUSINESSEXPERIENCE

Youranswerstothefollowingquestionswillhelpusunderstandyourapproachtobusinessoperations.

DoyoucurrentlyhaveacitybusinesslicenseforSignal Hill:YesNo

Whatis/wasyourcurrentorlast compensation method:$ % __DayWeekMonth

Doyoubookprivate or home clients:YesNoIfyes,howmuch do you chargeforthatservice:$

Doyoucarryyourowngeneralprofessionalliabilitypolicy:YesNoIfyes,pleasenamecarrier:

Doyouhave California Sellers Permit or Resale License:YesNo If yes, what is the number ______

Doyouhave anEmployerIdentificationNumber(EIN):YesNoIfno,doyouuseyourSSN?YesNo

Howdo youfeelaboutsellingproductsandservices:LikeNeutralDo NotLike

Haveyoueverparticipatedinaretailcompensationprogram:YesNoIfyes,explain:

Doyouadvertisetogetnewclients:YesNoIfyes,how:

Howmanyclientsonaveragewould you like to seeperweek:

Have you ever been independent (1099) contractor: Yes No
Do you prefer to be an employee or independent contractor: __

Pleaselistanyadditionalserviceorbusinessskillsyouhavethatwillassistyouinthepositionyouareseeking:

Application for Employment–Page 3

EMPLOYMENT HISTORY / GIVEEMPLOYMENT RECORD AS COMPLETELYASPOSSIBLE, LISTINGMOSTRECENT EMPLOYMENTFIRST,INCLUDE
EMPLOYED/SELF-EMPLOYED PERIODS AND PART-TIME OR SUMMERWORK
COMPANYNAME AND LOCATION / TELEPHONE / POSITION(S)
HELD / RATEOF PAY
(HR/WK/MO) / DATES
EMPLOYED / REASON FOR LEAVING / DESCRIPTION OF DUTIES
START:
END: / END:
FROM:
TYPE OFBUSINESS:
START:
END: / END:
FROM:
TYPE OFBUSINESS:
START:
END: / END:
FROM:
TYPE OFBUSINESS:
START:
END: / END:
FROM:
TYPE OFBUSINESS:
MAYWECONTACTTHESE EMPLOYERS?
YESNO / COMMENTS

ACKNOWLEDGEMENT

1. Iauthorizeallcorporations,companies, formeremployers,creditagencies,educationalinstitutions,lawenforcement agencies,city,state,countyand federalcourts,military servicesandpersonstoreleaseinformation theymayhaveaboutmetothepersonorcompany withwhichthisformhasbeen filed,ortheiragent,andreleaseallpartiesinvolvedfromanyliabilityandresponsibilityfordoingso.Ialsoauthorize theprocurementofaninvestigative consumerreportandunderstandthatitmaycontaininformationaboutmybackground, modeofliving,character andpersonalreputation. Thisauthorization, inoriginalorcopyform,shallbevalidforthisandanyfuturereportsorupdatesthatmayberequested. Furtherinformationmaybeavailableuponwrittenrequestwithinareasonableperiodoftime.

Checkthisboxifyouchoosetowaiveyour righttoreceivea copyofanypublicrecordobtainedpursuanttoCaliforniaCivilCodesection

1786.53. "Publicrecords"meansrecordsdocumentinganarrest,indictment,conviction,civiljudicialaction,taxlien,oroutstanding judgment.

2. Iunderstandthatif Iambeingconsideredfor employmentbythiscompany,Imaybe requiredto submitto a post-offerphysicalanddrug/alcoholtesting (allofwhichwillbepaidforbythiscompany)andtoauthorizethereleaseofthephysicalexamination andtestresultstothiscompany. Applicants whosetestresultsarepositive(prohibitedsubstancespresent)willnotbeeligibleforfurtheremploymentconsideration.

3. Any acceptanceofemploymentwillbepredicateduponthetruthfulnessofthewritten andverbalstatementscontainedwithinthisApplicationandpre- employmentprocess. IunderstandthatshouldmyemployerfindthatanystatementIhavemadeisnottruthful,anyjobextendedtomemaybe withdrawnand,ifemployed,I maybesubjecttotermination.

4.IauthorizetheNationalPersonnelRecordsCenter,St.Louis,Missouri,orothercustodianofmymilitaryrecordstorelease information or photo-

copies of my military personnel and related medical records, or only the following information/records.

Name: Service# Branch ofservice from to _

5. IunderstandthisApplicationforEmploymentisnottobeconfusedasaguaranteeofemploymentforaspecifictime. Ifurtherunderstandthatmy employmentwiththiscompanydoesnotconstituteanyformof contract,impliedor expressed,andsuchemploymentwillbeterminableatwilleitherby myselformyemployer uponnoticeofonepartytotheother. Mycontinued employmentisdependentonsatisfactoryperformanceandthecontinued needformyservicesasdeterminedbythisorganization.

6. Igrantmyemployerapproval,aftermyterminationofemploymenttoreleaseinformationwhichitmaydeemappropriateregardingmyemployment withorterminationfromtheorganization,toanyonewhohasareasonablebasisformakingsuchinquiry. Solongastheinformationdisclosed isnot knownbythisorganizationtobeinaccurate,thisorganizationshallnotincurlegalliabilityofanynatureinconnectionwiththefurnishingofsuch information.

7. IunderstandthatmyApplicationforEmploymentwillbeplacedinanactivestatusforaperiodofsixmonthsduringwhichtimeitwillbereviewedas jobopeningsoccurinmyarea(s)ofjobinterest. IalsounderstandthatshouldIwishtocontinuebeingconsideredforjobopeningsbeyondthesix monthperiod,Imustreapplyby(a)submittinganewApplicationforEmploymentor by(b)submittinga letterrequestingrenewalof myApplicationand includinganupdateofmyqualifications(recentworkhistory,educationalachievements,etc.).

8.I acknowledgethatI havereadalloftheabovestatementsandthatI understandthem.

ApplicantSignature

Date