Position Desired |
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Date of Application |
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Personal Information |
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First Name
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Middle Name |
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Last Name |
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Address |
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City |
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State |
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Zip |
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Day Phone |
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Evening Phone |
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Email Address |
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Date Available to Begin Work |
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Full or Part Time? |
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Salary Desired |
$
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How did you learn about this position? |
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Desired Shifts |
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Are you over 18 years of age? |
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Do you have dependable transportation? |
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Have you ever applied for a position with us? |
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| If "yes," when? |
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| Have you ever been employed with us? |
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| If "yes," when? |
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| Are you currently employed? |
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| If "yes," by whom? |
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| May we contact your present employer? |
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| If "no," please explain? |
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| If employment is offered, can you submit a birth certificate, social security card, certificate of U.S. citizenship, or verification of your legal right to work for Charles David Salon
in the U.S.? |
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| If employment is offered, can you produce personal identification such as a U.S. passport, a driver's license, or a photographic identification card issued by the State? |
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| Have you ever been known by another name? |
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If "yes," identify the name(s) and relevant dates.
(An affirmative response will not automatically disqualify you from being considered for employment. We need this information
to perform a complete check of work and education records). |
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| Have you ever been dismissed or forced to resign from any employment? |
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If "yes," please explain.
(An affirmative response will not automatically disqualify you from being considered for employment). |
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| Have you ever been convicted of a felony, pleaded guilty or "no contest" to a felony, and/or received deferred adjudication for a felony offense? |
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If "yes," please explain.
(An affirmative response will not automatically disqualify you from being considered for employment). |
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| Are you able, with or without reasonable accommodation, to perform all the essential functions listed in the job description for which you are applying? |
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If you are applying for a position involving evening or weekend work, are you available to work at those times?
(A negative response will not automatically disqualify you from being considered for employment). |
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Are you willing to work overtime as requested?
(A negative response will not automatically disqualify you from being considered for employment). |
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| Educational Data |
| High School |
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| School Name |
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| School City |
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| School State |
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| Year Graduated |
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| College |
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| School Name |
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| School City |
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| School State |
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| No. of Years Completed |
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| Degree |
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| Major Course of Study |
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| Graduate School |
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| School Name |
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| School City |
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| School State |
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| No. of Years Completed |
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| Degree |
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| Major Course of Study |
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| Vocational School |
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| School Name |
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| School City |
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| School State |
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| No. of Years Completed |
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| Major Course of Study |
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| Employment History |
| In the following spaces, give a complete record of your employment, including periods of unemployment, if any. Begin with you most recent employment, and work back in time. |
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| Employer 1 |
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| Employer Name |
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| Address |
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| City |
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| State |
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| Zip |
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| Duration |
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| Starting Position |
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| Last Position |
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| Other Positions Held |
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| Immediate Supervisor |
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| Starting Salary |
$
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| Final Salary |
$
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| Duties |
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| Reason for Leaving |
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| Employer 2 |
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| Employer Name |
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| Address |
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| City |
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| State |
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| Zip |
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| Duration |
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| Starting Position |
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| Last Position |
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| Other Positions Held |
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| Immediate Supervisor |
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| Starting Salary |
$
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| Final Salary |
$
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| Duties |
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| Reason for Leaving |
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| Employer 3 |
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| Employer Name |
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| Address |
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| City |
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| State |
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| Zip |
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| Duration |
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| Starting Position |
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| Last Position |
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| Other Positions Held |
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| Immediate Supervisor |
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| Starting Salary |
$
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| Final Salary |
$
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| Duties |
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| Reason for Leaving |
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| Employer 4 |
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| Employer Name |
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| Address |
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| City |
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| State |
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| Zip |
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| Duration |
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| Starting Position |
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| Last Position |
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| Other Positions Held |
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| Immediate Supervisor |
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| Starting Salary |
$
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| Final Salary |
$
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| Duties |
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| Reason for Leaving |
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| Special Skills
or Qualifications |
| Describe any other special job-related skills or qualifications (e.g., union experience, military experience and training, computers, professional associations, licenses, etc.) that
would be valuable to the position for which you are applying. |
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| References |
| Reference 1 |
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| Name |
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| Phone |
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| Occupation |
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| Reference 2 |
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| Name |
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| Phone |
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| Occupation |
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| Reference 3 |
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| Name |
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| Phone |
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| Occupation |
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| Applicant's Statement |
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements
on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning
my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to
the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited
by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.” |
| Full Name (signature) |
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| Today's Date (mm/dd/yyyy) |
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| To submit your application directly to charles david salon & spa over the internet click the Submit button |
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*click here f you would rather print this application, fill it out later and mail it yourself
. Please mail to:
Charles David Salon & Spa
222 Webster Street
Hanover, MA 02339
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