Personal Information
First Name:	Last Name:
Street Address:
City:	State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code:
Phone Number:	Email Address:
Are you 18 years or older? Yes No
Have you even been convicted of a felony or misdemeanor? Yes No
If yes, please explain?

Desired Employment
Position applying for: Receptionist Esthetician Nail Technician Massage Therapist
Other
Date you are available to start:	Salary / hourly desired:
Applying for? Part-time Full-time
Hours / days NOT available:
Are you employed now? Yes No
If yes, may we inquire of your present employer? Yes No

Education
High School:	Did you graduate? Yes No
If you are still attending high school, what grade are you in?
College:	Did you graduate? Yes No
Trade or other school:	Did you graduate? Yes No
Special training, skill, or study:

Employment History
Present or last employer:	Phone Number:
Salary / hourly wage:	May we contact them? Yes No
Job title and description of work:
Previous Employer:	Phone Number:
Salary / hourly wage:	May we contact them? Yes No
Job title and description of work:
Previous Employer:	Phone Number:
Salary / hourly wage:	May we contact them? Yes No
Job title and description of work:

References
Please list three persons you are not related to, whom you have known at least one year:
Reference 1 Name:	Phone Number:
Business:	Years Acquainted:
Reference 2 Name:	Phone Number:
Business:	Years Acquainted:
Reference 3 Name:	Phone Number:
Business:	Years Acquainted: