Employment Application

HOLLYWOOD TANS FAIRFAX & SPRINGFIELD

EMPLOYMENT APPLICATION

* Required fields
Name *
E-mail Address *
Date
Present Address - Street
City
State
Zip code
Date of Birth
Cell Phone *
Home Phone
Referred by
Permanent Address - Street
City
State
Phone
Location Preferred
Are you willing to work at both locations? *
Start Date
Salary Desired
Position
Have you ever worked at a Hollywood Tans before?
Do you certify that you are a U.S. Citizen, permanent resident, or a foreign national with authorization to work in the United States? *
Have you ever been convicted of, or entered a plea of guilty, no contest, or had a withheld judgement to a felony? *
High School / College
City
State
Zip code
Major Studied
What year are you?
Special study and skills
Are you currently employed?
May we contact your present employer?
Name of employer
Date employed ( from - to )
Street
City
State
Zip code
Phone Number
Salary / Wage
Position / Responsibility
Name of Supervisor
Phone number
Reason for leaving
Name of employer
Date employed ( from - to )
Street
City
State
Zip code
Phone number
Salary
Position / Responsibility
Name of supervisor
Phone number
Reason for leaving
Reference name 1
Years known
Address
Phone number
Relation
Reference name 2
Years known
Address
Phone number
Relation
Availabities
Number of Weekly Hours Desired *
Mon *
Tues *
Wed *
Thur *
Fri *
Sat *
Sun *


Please enter the code shown above and click the 'Submit Form' button. This additional step is required to help protect against message spam.



I CERTIFY, by hitting 'Submit,' 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 agreements contrary to the foregoing unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release of use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.