PRINT AND COMPLETE

GLADYS DOMINICAN SALON

Employment Application
We are an equal opportunity employer, and adhere to a policy of nondiscrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions.
Today’s Date _______________

I. PERSONAL INFORMATION
Name: Last___________________________________ First____________________
Middle_______________
Address
Email address
RMT License #___________________ Georgia Cosmetology License #___________________
Georgia Barber License # ________________________

Social Security Number _____________________

Home Telephone ________________________Cell Phone_________________________________
What Position are you Applying For?:__________________________
Is there any information we would need about your name or use of another name for us to be able
to check your work record? Please specify:_________________________________________________________________________
Do you have any relatives who are presently (or have formerly been) employed by
Gladys Dominican Salon?
_____________________________________________________________________
How were you referred to us?

II. EDUCATION HISTORY
School Name/Location Years Completed Degree/Diploma
High School
College
Tech. Training
Other Schools
Specialty Trainings__________________________________________________________________________

III. EMPLOYMENT HISTORY (Please include all employment for the last 5 years.)
1.
Company Name (Current or Most Recent Employer) Position Held
Dates Employed:
Address From To
Manager / Supervisor Telephone Wage/Salary
Reason For Leaving

2.
Company Name Position Held
Dates Employed:
Address From To
Manager / Supervisor Telephone Wage/Salary
Reason For Leaving
3.
Company Name Position Held
Dates Employed:
Address From To
Manager / Supervisor Telephone Wage/Salary
Reason For Leaving

NOTE: Use a separate sheet to list additional employers, if necessary. We will contact all of the
employers listed on this application unless you specifically exclude them below. Please list any
employers you do not want us to contact and your reason for the exclusion:
(Employer’s Name) Reason
(Employer’s Name) Reason

IV. REFERENCES Please do not include relatives or former employers.
1.
Name Years Known
Address Telephone
Occupation
2.
Name Years Known
Address Telephone estheticians
Occupation

V. WORK AVAILABILITY

• If your application receives favorable consideration, when will you be available to begin
work?
• Do you have any objection to working overtime? ( ) Yes ( ) No
• Can you work overtime without prior notice? ( ) Yes ( ) No
Can you work on Saturday? ( ) Yes ( ) No
Can you work on Sunday? ( ) Yes ( ) No
• Can you work evenings? ( ) Yes ( ) No
• Shift preference: ( ) Any ( ) a.m. 8:30-1:45 ( ) p.m. 1:30-5:30 ( ) p.m. 1:30-9:00

VI. SALARY/HOURLY RATE REQUIREMENT
If your application receives favorable consideration, what salary/hourly or
commission rate would you require? $ _______ per ______.

Signature

Date

Please fax to your job application to:
Gladys Dominican Salon
Fax: 678.840.0092
Or feel free to mail to, or drop it by the Salon at:
5895 Jimmy Carter Blvd
Norcross, Georgia 30071
Ph: 770.662.4930