Application Form

Personal Information

First Name*

Last Name*

Business Name

Address

City *

Zip *

Email *

Mobile Telephone *

Professional License Number *

Renewal Date *

Type of License *

Work History

Present Salon Name

Date Worked From

Are you on salary, commission or rental?

Other Information

Desired Suite Number

Desired Date of Occupancy

How did you hear about us?

Name of Referral

In The Past Seven Years

Have you been disciplined by any State or Local Agency?

Have you been convicted of or plead guilty to any criminal or felony offense?

Are you presently charged with any felony violations of law?

Have you ever been evicted for any reason from a Landlord?

Have you ever broken a Lease Agreement?

If your answer is YES to any of the preceding questions or any part of the questions, please provide the detail below to include the date, place and nature of each such conviction(s) or pending charge(s). (The existence of a conviction or pending charge will not necessarily preclude you from leasing or employment. The nature of the crime and its relationship to the lease or position applied for, the degree of rehabilitation and the time elapsed since the crime or release from confinement will all be considered.)

Explain

Personal References (aside from family members)

Name

Address

Phone

Name

Address

Phone

Emergency Contact

Name

Address

Phone

Name

Address

Phone

Identification Information

Social Security Number

Drivers License Number

Date of Birth

Car (Make, Model, Year, and License#)

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Disclaimer: By filling out this application we have the authorization and permission to run a background check for any applicant