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Employment Desired

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Position Desired

Full-Time
Part-Time
Full or Part-Time

Are there any days or times that you are not available to work? Please list.

If applicable for the position you’re applying for, do you hold a valid technical license?

Yes No

Yes No

Yes No

Yes No

Were you referred by a current Urban Girls Salon Employee?

Yes No

If so, please state citation, date, and place where offense occurred

Provide details of the above, including the nature of the offense and successful rehabilitation attempts since the conviction

Do you have any felony charges pending against you?

Employment History

Please include ALL work experience beginning with your most recent job held. Attaching a resume will not substitute for completing this section of the application.

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Education

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High School

Name and Location of School

Did you graduate with a degree or diploma?

Subjects Studied

Trade, Business or Other School

Name and Location of School

Did you graduate with a degree or diploma?

Subjects Studied

College

Name and Location of School

Did you graduate with a degree or diploma?

Yes No

Subjects Studied

Yes No

Yes No

Professional References

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Please give the names, phone numbers, and relationship of three professional references not related to you.

Reference One

Name

Phone

Relationship

Reference Two

Name

Phone

Relationship

Reference Three

Name

Phone

Relationship

General

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What interests you about working at Urban Girls Salon?


You are not required to disclose information about physical or mental limitations that you believe will not interfere with your capability to do this job. However, if you want the employer to consider special arrangements to accommodate a physical or mental impairment, you may identify that impairment in the space provided and suggest the kind of accommodation that you believe would be appropriate.



I certify that all answers and statements on this application are true and complete to the best of my knowledge. I understand that if I omit, misrepresent or falsify any information on this application, during the hiring process or, if I am hired, during employment, my application may be rejected, the hiring process discontinued, or my employment with this company terminated.

I also understand that if hired, my employment relationship will be at-will, and that either I or Urban Girls Salon may terminate the employment relationship with or without cause and with or without notice. I further understand that this employment relationship may not be modified by verbal statements, customs, practices, or written documents unless such modification is in writing and signed by an authorized agent of Urban Girls Salon.

Notice: Michigan and Federal law require employers to make accommodations to disabled applicants and employees where the accommodation does not impose an undue hardship on the employer. Disabled employees and applicants may request an accommodation of their disability by notifying the Company in writing of the need for accommodation. Michigan law requires such notification within 182 calendar days of the date the individual knows or should have known that an accommodation was needed. Failure to properly notify the Company will serve as a defense to any failure to accommodate claim.

I understand and agree that any claim, complaint, action or suit relating to this application and/or the hiring process, and/or my employment if I am hired, including any discrimination claims, must be filed within whichever of the following time periods is less: (i) not more than one hundred eighty-two (182) calendar days after the event giving rise to the claim, complaint, action, or suit; or (ii) later than the applicable limitations period established by statute.

I understand that by signing this application I authorize Urban Girls Salon to contact former employers (other than those specifically excepted) and listed references for the purpose of verifying information.

Signature:

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