The Tanning Studio & Urban Chic Boutique Application

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Driver's License # *

Are you 18 years of age or older? *

Yes

No

Position you are applying for *

Desired Rate *

Were you referred by anyone and how did you hear about the opening? *

Have you ever been convicted of a felony within the last 5 years? If yes, please explain. *

Please choose the Studios you are willing to work at *

Wausau

Weston

Plover

AVAILABILITY - Days & times you are willing to work (ex. 1pm-9pm or any hours)

Monday *

Tuesday *

Wednesday *

Thursday *

Friday *

Saturday *

Sunday *

EMPLOYMENT HISTORY - Please list your last three employers, starting with the most recent.

1. Employer *

City *

Start Date & End Date *

Supervisor's Name & Title *

Position *

Starting Hourly Rate &/or Ending Hourly Rate *

Describe Duties *

Reason for Leaving *

2. Employer *

City *

Start Date & End Date *

Supervisor's Name & Title *

Position *

Starting Hourly Rate &/or Ending Hourly Rate *

Describe Duties *

Reason for Leaving *

3. Employer *

City *

Start Date & End Date *

Supervisor's Name & Title *

Position *

Starting Hourly Rate &/or Ending Hourly Rate *

Describe Duties *

Reason for Leaving *

Additional Employment Information:

Education History

High School Name: *

Highest Grade Level Completed *

College Name:

College Degree(s)

Special training or skills that may qualify you for a the position

I certify that the statements contained herein are true and correct to the best of my knowledge, and I understand that any false statements or omissions by me on this application and any other required document is considered a cause for denial of employment or discharge, whenever discovered. I understand that this document is an application for employment, and does not constitute an agreement or contract for employment of any length of time. If hired, I have the freedom to quit at any time. The employer also has the right to terminate my employment with or without cause, the exceptions being as required by law.

I authorized the above employer to investigate all information in the above application for employment. The employer has the right to contact previous employers, schools, and other references to verify this information. I release the employer from any liability in gathering this information. I release from liability any companies or instructions supplying this information. After termination of my employment, for whatever reason, I release the above employer from liability for any information supplied to future potential employers.

Signature *