Application for Employment

Name: Suddenly Slimmer Med Spa
Price range: $$

Position Applied For(Required)

Date

MM slash DD slash YYYY

Personal Data

Salary expectations(Required)

Name(Required)

First Middle Last

Email(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Telephone(Required)

If you are under 18 years of age, please specify your age

(This information will be used only for child labor law purposes).

What is your Instagram handler

Are there any days, shifts or hours you will not work?*(Required)

Yes

If yes, please explain

Will you work overtime, if required?*(Required)

Yes

*Note: It is not necessary for you to identify unavailability for work because of religious observance or practice or any other protected classification. Subsequent to any job offer, we will consider whether a reasonable accommodation can be made.

When will you be able to start work?(Required)

How did you learn of the Company?

Have you ever applied or worked for the Company before?(Required)

Yes

If yes, provide dates:

Are you legally authorized to work in the United States?(Required)

Yes

If you were referred to us, please prove the following:

Person’s full name:

Relationship to you:

DRIVING RECORD

(Answer only if driving is a requirement of the job for which you are applying).

Do you have a valid & current driver’s license?(Required)

Yes

State

License No.

Do you have your own vehicle(Required)

Yes

Have you had any tickets?(Required)

Yes

CRIMINAL RECORD

Yes

If yes, please explain:

Please complete all full-time or part-time employment beginning with most recent employer. You may include as part of your employment history any verified work performed on a volunteer basis. All applicants should start with their most recent job, include military assignments and voluntary employment and provide ten (10) years of history. (A separate sheet may be attached.) You must explain any gaps in your employment history.

Company Name:

Telephone

Address

Name of Supervisor

May we contact

Yes

Dates Employed:

From

Dates Employed

State job titles and describe job duties

Reason for leaving

Have you ever been discharged or asked to resign from employment?(Required)

Yes

If yes, explain:

Did you receive any discipline in your last 12 months of active employment with your previous employer?(Required)

Yes

If yes, explain:

Were you given a performance evaluation within the last 12 months of active employment?(Required)

Yes

If yes, what was the range of scores used and what was your score?

If hired, would you be able to help promote the company on our social media page by liking, reposting, commenting on our Facebook and Instagram pages?(Required)

Yes

We have a no cell phone policy in the spa, where you must keep your cell phone in the employee locker. Are you able to comply with that?(Required)

Yes

Have you signed any non-competition or non-solicitation agreement or any other kind of agreement with any other employer that might restrict you from working for the Company ?(Required)

Yes

If yes, please explain:

(Please list three individuals unrelated to you with whom you have worked for who know your qualifications for this position.)

Name

Business Email

Phone

Relationship

Name

Business Email

Phone

Relationship

Name

Business Email

Phone

Relationship

Consent(Required)

I agree to the privacy policy.

I certify that the answers given herein and during the entire application process (including but not limited
to information provided in resumes, attachments to this application, interviews or otherwise (if applicable))
are true and complete to the best of my knowledge.
I understand that any misrepresentations, omissions of facts or incomplete answers during the application
process may disqualify me from further consideration for employment. I further understand that, if
employed, any misrepresentations or omissions of facts during the application process may be cause for
my dismissal at any time without prior notice.
I consent to and authorize the Company and ADP TotalSource®
to contact my
former employers, references, and any and all other persons and organizations
for information bearing upon my qualifications for employment.
I further authorize the listed employers, schools and personal references to give
the Company or ADP TotalSource (without further notice to me) any and all
information about my previous employment and education, along with any other
pertinent information they may have and hereby waive any actions which I may
have against either party(ies) for providing a good faith reference.
I EXPRESSLY AGREE AND UNDERSTAND THAT, IF EMPLOYED, MY EMPLOYMENT IS NOT FOR A
SPECIFIC TERM, IS BASED ON MUTUAL CONSENT AND MAY BE TERMINATED BY ME OR THE
COMPANY OR ADP TOTALSOURCE WITH OR WITHOUT NOTICE OR CAUSE AT ANY TIME. I
FURTHER UNDERSTAND THAT NO ORAL PROMISE, EMPLOYER POLICY, CUSTOM, BUSINESS
PRACTICE OR OTHER PROCEDURE (INCLUDING THE BASIC EMPLOYMENT POLICIES,
PERSONNEL HANDBOOK OR ANY PERSONNEL MANUALS) CONSTITUTES AN EMPLOYMENT
CONTRACT OR MODIFICATION OF THE AT-WILL EMPLOYMENT RELATIONSHIP BETWEEN ME
AND THE COMPANY OR ADP TOTALSOURCE.
I ALSO UNDERSTAND THAT MY AT-WILL EMPLOYMENT STATUS WITH THE COMPANY MAY ONLY
BE ALTERED IN AN INDIVIDUAL CASE OR GENERALLY IN A WRITING SIGNED BY THE OWNER,
PRESIDENT OR CEO OF THE COMPANY AND THAT MY AT-WILL STATUS WITH ADP
TOTALSOURCE MAY ONLY BE ALTERED IN AN INDIVIDUAL CASE OR GENERALLY IN A WRITING
SIGNED BY THE PRESIDENT OF ADP TOTALSOURCE.
I understand that I may be required to qualify for employment based on additional employment criteria.
For example, I may be required to take job-related tests; take a driver’s examination or take a
pre-employment drug test. If I am offered employment or start work before any required test is completed,
I understand that my employment is contingent on a satisfactory result on all required tests. I authorize
the Company and ADP TotalSource to release the results of my pre-employment drug/alcohol test (if any),
any information on this application and any relevant information about me to each other and to other ADP
TotalSource clients for whom I have applied for employment, and release the Company, ADP TotalSource
and its clients from any and all claims related to the lawful release of this information. I further authorize
the release of any background check results and of any drug/alcohol test to any state or federal authority
requesting such information and in response to a valid subpoena or other legal document.
CALIFORNIA APPLICANTS ONLY: I understand the Company or ADP TotalSource may obtain, without
using the services of a third party investigative consumer reporting agency, public records pertaining to
my character, general reputation, personal characteristics or mode of living during its evaluation of my
application for employment and, if employed, during my employment. By checking the following box, I
waive my right to receive copies of public records obtained by the Company or ADP TotalSource.

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