Name (first, middle initial, last):

Position Applying For:

Email Address:

Street Address:

Unit #:

City:

State:

Zip Code:

How long have you lived at your current address?

Phone:

Are you under 18 years old?

Are you legally eligible to work in the U.S.?

Are there any times when you are unable to work (if yes, when?)?

EDUCATION

High School (name, city, state)

Graduation Date (month/year):

Cosmetology School (name, city, state):

Graduation Date (month/year):

College (name, city, state):

Dates Attended?

Graduated?

Other (name, city, state):

Dates Attended?

Graduated?

Please list any advanced education or training classes you have attended.  List the class name and details of training, location (city/state), and date(s) attended.

EMPLOYMENT HISTORY

Please list employment history for the past five years, starting with your most recent position.

Name of Employer:

Employer Address (street, city, state, zip code)

Employer Phone:

Name of Supervisor(s):

Job Title:

Employment Dates (month/year):

Pay/Salary (gross):

Reason for leaving (be specific):

Average hours worked per week:

Job Details (duties, promotions received,etc.)

Name of Employer:

Employer Address (street, city, state, zip code):

Employer Phone:

Name of Supervisor(s):

Job Title:

Employment Dates (month/year):

:

Pay/Salary:

Reason for Leaving (be specific):

Average Hours Worked per Week:

Job Details (duties, promotions received, etc.):

Name of Employer

Employer Address:

Employer Phone:

Name of Supervisor(s):

Job Title:

Employment Dates (month/year-month/year):

Pay/Salary:

Reason for Leaving (be specific):

Average Hours Worked Per Week:

Job Description (duties, promotions received, etc.):

Additional Information:  Please use the area below to complete your employment history if needed, answering the same questions as listed above.  Also, list any retail or color lines that you have worked with in the past.

Please use the area below to explain any gaps in employment longer than one month:

May we contact your present employer?

Why do you want to work at LaMode Salon?

Name three strengths that you would bring to LaMode Salon:

Name three areas that you would like to improve upon:

What kind of work environment do you thrive in?

Did you complete this application yourself?  If not, who did?

I certify that the information provided on this application is true and accurate to the best of my knowledge.

APPLICATION FORM WAIVER

In exchange for the consideration of my job application by LaMode Salon Inc.  (hereinafter called “the Company”), I agree that:  Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of LaMode Salon Inc., or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company.  Both the undersigned and LaMode Salon Inc. may end the employment relationship at any time, without specified notice or reason.  If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.   I authorize investigation of all statements contained in this application.  I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice.  I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.

I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living.  Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

This Company is an equal employment opportunity employer.  We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability.  We assure you that your opportunity for employment with this Company depends solely on your qualifications.

I have read and understand the above Application Waiver.