Samsara Salon & Spa | Employment Application

410-552-6900

7606 Main Street
Sykesville, MD 21784

T-Th 10-8 | F 9-8 | Sat 9-4

PERSONAL INFORMATION

Position Desired

Name (First and Last)

Phone

Address

City

State

Zip

Are you presently employed?
Yes No

What is your desired pay?

Available to start (--/--/--):

Please choose your hours of availability

Have you ever applied here before? Yes No If yes, which position? Date (--/--/--):

Can you submit verification of your identity and legal right to work in the United States? Yes No

Employment type desired: Full time Part time Temporary Internship Seasonal (summer/holidays)

Are you 18 years of age or older? Yes No If under 18, do you have a work permit? Yes No

What prompted you to apply? Have you ever been convicted of a felony? Yes No

Why do you want to join the Samsara team?

What do you believe would be your greatest contribution to our salon?

QUALIFICATIONS
Certified Position: Licenses/Certifications	Qualifications and special skills
State License Number (include state)
Other

EDUCATION AND TRAINING
High School	City	State	Did you graduate? Yes No Not Yet If yes, date graduated(--/--/--)
College	City	State	Did you graduate? Yes No Not Yet If yes, date graduated(--/--/--)
Industry Academy / Beauty School	City	State	Did you graduate? Yes No Not Yet If yes, date graduated(--/--/--)
Other Training, Education and Honors

EMPLOYMENT HISTORY
Employer	Date Hired (--/--/--)	Date Left (--/--/--)	Supervisor Name	Position
Phone	Salary	Duties
May we contact your employer? Yes No		Reason for Leaving

Employer	Date Hired (--/--/--)	Date Left (--/--/--)	Supervisor Name	Position
Phone	Salary	Duties
May we contact your employer? Yes No		Reason for Leaving

Employer	Date Hired (--/--/--)	Date Left (--/--/--)	Supervisor Name	Position
Phone	Salary	Duties
May we contact your employer? Yes No		Reason for Leaving

REFERENCES (Please provide contact information for 3 individuals NOT related to you)
Name	Phone	Relationship to You	Years Known
Name	Phone	Relationship to You	Years Known
Name	Phone	Relationship to You	Years Known
"I certify 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 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 agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."
Yes, I understand the terms of this application (Checking this box online replaces the need for a signature)
Applicant Signature (Please type name if completed online)		Date (--/--/--)