Date

    Last Name *

    First Name *

    Street Address *

    City *

    State *

    Zip Code *

    Telephone *

    Email *

    Are you a US Citizen ? *

    YesNo

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

    YesNo

    Have you ever been convicted of a crime? *

    YesNo

    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 ?

    CraigslistWebsiteReferralWalkInOther

    Position

    Days Available ?(Check all those apply) *

    Open AvailabilitySundayMondayTuesdayWednesdayThursdayFridaySaturday

    Employment Desired ? *

    Position Applied for ? *

    Are you available to work nights and weekends ? *

    YesNo

    Salary Desired

    Education

    Name Of School

    Degree

    Address

    From

    To

    Did you graduate?

    YesNo

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

    Degree

    Address

    From

    To

    Did you graduate?

    YesNo

    Additional Information(Use if additional space is needed)

    Professional - License & Skills

    Do you have a current barber license in the State of VA?

    YesNoI 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)

    ClipperScissorStraight Razor ShavesBeard TrimsFades - In addition to clipper skillsHair Color/Grey BlendingSkin CareOther

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

    Are you able to stand for long periods of time?

    YesNo

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

    Work History

    Please list your previous work History

    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?

    YesNoOther

    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. *

    YesNoOther