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| To complete the online application, simply type you answers in the corresponding fields. Once you have completed the application, click the "submit" button located at the bottom of the page. All information is confidential and shared with only staff of Veronyka's. |
| PERSONAL INFORMATION |
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| Last Name |
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| First Name |
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| Address |
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| City |
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| State |
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| Zip Code |
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| Phone Number |
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| Are you 18 years
or older? |
Yes
No |
| DESIRED EMPLOYMENT |
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| Position |
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| Date you can start (mm/dd/yy) |
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| Salary desired
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| Are you employed
now? |
Yes
No |
| If so, may we
inquire of your present employer? |
Yes
No |
| Ever applied to
this company before? |
Yes
No |
| Where? |
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| When? |
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| Ever worked for
this company before? |
Yes
No |
| Where? |
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| When? |
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| Reason for leaving |
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| Name of last supervisor
at this company |
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| Referred by |
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| EDUCATION |
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| Grammar School
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| Did you graduate? |
Yes
No |
| Subjects studied
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| High School |
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| Did you graduate? |
Yes
No |
| Subjects studied
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| College |
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| Did you graduate? |
Yes
No |
| Subjects studied
|
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| Trade, business
or correspondence school |
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| Did you graduate? |
Yes
No |
| Subjects studied
|
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| GENERAL |
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| Subjects of special
study or research work |
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| Special Training
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| Special Skills
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| FORMER EMPLOYERS |
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| Name of last or
present employer |
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| Address |
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| City |
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| State |
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| Zip code |
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| start date (mm/dd/yy) |
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| leaving date (mm/dd/yy) |
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| Job title |
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| Weekly starting
salary |
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| Weekly final salary |
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| May we contact
your supervisor? |
Yes
No |
| Description of
work |
|
| Reason for leaving |
|
| |
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| Name of previous
employer |
|
| Address |
|
| City |
|
| State |
|
| Zip code |
|
| start date (mm/dd/yy) |
|
| leaving date (mm/dd/yy) |
|
| Job title |
|
| Weekly starting
salary |
|
| Weekly final salary |
|
| May we contact
your supervisor? |
Yes
No |
| Description of
work |
|
| Reason for leaving |
|
| |
|
| Name of previous
employer |
|
| Address |
|
| City |
|
| State |
|
| Zip code |
|
| Starting date (mm/dd/yy) |
|
| Leaving date (mm/dd/yy) |
|
| Job title |
|
| Weekly starting
salary |
|
| Weekly final salary |
|
| May we contact
your supervisor? |
Yes
No |
| Description of
work |
|
| Reason for leaving |
|
| REFERENCES |
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| Reference # 1
Name |
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| Address |
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| Business |
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| Years acquainted
|
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| Reference # 2
Name |
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| Address |
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| Business |
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| Years acquainted
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| Reference # 3
Name |
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| Address |
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| Business |
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| Years acquainted
|
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| SERVICE RECORD |
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| Branch of service |
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| Discharge date
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| Rank |
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| Have you been
convicted of a felony in the last 5 years? |
Yes
No |
| If yes, explain
(will not necessarily exclude you from consideration) |
|
| AUTHORIZATION |
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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. |
| Veronyka's Color Spa & Salon is an equal opportunity employer. |
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