Application

Date

Last Name *

First Name *

Street Address *

City *

State *

Zip Code *

Telephone *

Email *

Your Age

Are you a US Citizen ? *
 Yes No

If no, are you authorized to work in the US?
 Yes No

Have you ever been convicted of a crime? *
 Yes No

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Date Available *

How did you hear about us ?
 Craigslist Website Referral WalkIn Other


Position

Days Available ?(Check all those apply) *
 Open Availability Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Employment Desired ? *

Position Applied for ? *

Are you available to work nights and weekends ? *
 Yes No

Salary Desired

Education

Name Of School

Degree

Address

From

To

Did you graduate?
 Yes No

Name Of School(If you attended one (1) school, go to Professional License Section.)

Degree

Address

From

To

Did you graduate?
 Yes No

Additional Information(Use if additional space is needed)

Professional - License & Skills

Do you have a current barber license in the State of VA?
 Yes No I have a cosmetology license

License number(Enter N/A if this doesn't apply for the position you are applying for)

License Expiration Date

Skillsets ?(Check all those apply)
 Clipper Scissor Straight Razor Shaves Beard Trims Fades - In addition to clipper skills Hair Color/Grey Blending Skin Care Other

How many years of experience do you have being a barber?

Are you able to stand for long periods of time?
 Yes No

Additional Information(Please summarize any additional information necessary to describe your qualifications for the specific position you are applying for.)

Professional References

Please list two (2) professional references

Reference* (Full Name)

Relationship (How do you know your reference?)

Phone(Best phone number to reach your reference?)

Reference* (Full Name)

Relationship (How do you know your reference?)

Phone(Best phone number to reach your reference?)

Disclaimer and Electronic Signature

Did you complete this application yourself?
 Yes No Other

EMPLOYMENT APPLICATION DISCLAIMER AND ACKNOWLEDGEMENT I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired. I authorize any person, organization or company listed on this application to furnish you any and all information concerning my previous employment, education and qualifications for employment. I also authorize you to request and receive such information. In consideration for my employment, I agree to abide by the rules and regulations of the company, which rules may be changed, withdrawn, added or interpreted at any time, at the company’s sole option and without prior notice to me. I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of the company or myself. *
 Yes No Other