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Kathy Adams Salon

Kathy Adams Salon thanks you for your interest. Please take your time in completing this application so that we obtain a clear understanding of your qualifications, background, and work history. Feel free to use the back of application for additional information that you feel will aid us in making our decision.

** The following must be read before completing this application:

The Civil Rights Act of 1964 prohibits discrimination because of race, color, sex, or national origin. Federal law also prohibits discrimination on the basis of age with respect to certain individuals. The laws of most states also prohibit some or all of the above types of discrimination as well as some additional types such as discrimination based upon ancestry, marital status or physical or mental handicap or disability. DO NOT answer any questions you feel will violate your rights.

Position Applying For:___________________________ Date:____________________

Desired schedule:
Day/Time Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Personal Information

Full Name____________________________________________ SS#______________________________________

Present Address__________________________________________________________________________________________

Tel#_________________________ Emergency Tel#___________________________ Relationship______________________

How long have you lived at your present address?________________ Date of Birth_______________ Sex: Male___ Female___

Have you ever been convicted of a crime, excluding misdemeanors, in the past 10 yrs? If yes, describe in full. ___________________________________________________________

Do you have any physical condition, which may prevent you from performing certain salon-related work? If yes, describe the condition and related work

Have you had a major illness in the past 5 yrs.? If yes, describe in full. _______________________________________________________

Have you received compensation for any injuries? If yes, describe in full. _____________________________________________________

Date you can start______________ Salary desired_____________ Are you employed now? If so may we inquire of your present employer? _ ______________________________________________________________________________________

How did you hear about our salon?________________________________________________________



High School____________________________ Location________________________ Did you graduate?________________
College_______________________________ Location________________________ Did you graduate?________________
Trade School___________________________Location________________________ Did you graduate?________________
Cosmetology School______________________ Location________________________ Hours Completed________________
Date Licensed___________________ State first licensed in___________________________

Advanced courses you have taken relating to the salon industry? State subject, year and source.
1. ___________________________________________________________________________
2. ___________________________________________________________________________
3. ___________________________________________________________________________

Employment History

Number of yrs. In salon industry?____________ List areas of special interest (ex. Cutting, color)_________________________________
Do you have any management experience in the salon industry___________ Are you interested in exploring management opportunities? __

Former and/or current employers (please list below 3 employers, starting with last one first):

Name and Address Dates(from-to) Salary Reason for leaving Tel#

Which of these jobs did you like the best? And why?____________________________________________________________________________

Please read the following and sign below
The facts set forth in my application for employment at this salon are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. I give you authorization to make any inquiries of my personal history in establishing my credibility for employment at this salon. This includes any personal interviews with past employers and references as to my personal character and general reputation. I understand that I have the right to make a written request within a reasonable period of time to receive additional information regarding such inquires.

Signature of Applicant___________________________________________ Date________________

Please do not write below this line
Interviewed by____________________________ Date__________________ Remarks______________________________________________________________________
Employer contacted_______________________________________________ Comments____________________________________________________________________
Schools contacted_________________________________________________ Comments____________________________________________________________________
Hired?_________________ Date_________________ Position________________________ Wage_________________________
(770) 831 - 7874