Utopia Salon and Spa

Position Applied for *
Employment type *
Date
Name

First *

Last *

Middle

Present Address

Street *

City *

State *

Zip *

How long at Present Address?

Years *

Months *

Previous Address

Street

City

State

Zip

How long at Previous Address?

Years

Months

Telephone No. *
Email Address: *
Are you a licensed Cosmetologist:

State License No (please include state):

Record of Previous Employment

Please list the name of your present or previous employers in chronological order with present or last employer listed first. Be sure to account for all periods of time including military service and any period of unemployment. If self-employed, give firm name and supply business references.

Present or Last Employer *

Address *

City, State, Zip *

Telephone *

Employed(From/To)

Pay(Start/Finish)

Title or Position

Name and Title of Supervisor

Exact Reason for Leaving

Present or Last Employer

Address

City, State, Zip

Telephone

Employed(From/To)

Pay (Start/Finish)

Title or Position

Name and Title of Supervisor

Exact Reason for Leaving

Present or Last Employer

Address

City, State, Zip

Telephone

Employed(From/To)

Pay (Start/Finish)

Title or Position

Name and Title of Supervisor

Exact Reason for Leaving

Have you ever been terminated or asked to resign from any job? If Yes please explain the circumstances

Please explain fully any gaps in your employment history:

May we contact your current employer? If No, please explain: *

Please indicate any qualifications or special skills.

Have you ever used another name? Is any additional information relative to change of name, use of an assumed name, or nickname necessary to enable a check on your work and educational record? If yes, please explain.

Education

School Name:

Years Completed

Diploma/Degree

High School *

College/Univ.*

Grad/Professional

Industry Academy/Beauty

School

Other:

Professional References

Please list persons who know you well - exclude previous employers or relatives

Name

Occupation

Address (Street, City, State)

Telephone Number

Number of Years Known

* I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE AND ACCURATE.

This application will be considered active for a maximum of thirty (30) days. If you wish to be considered for employment after that time you must reapply.

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