Employment Opportunities - Online Application

Name:

Address:

City:

State:   Zip:

Telephone:

E-mail:

Social Security:

Position Sought:

Desired Wage:

Date Available:

Hours/Week Available:

Are You Under 18 Years of Age? 
Yes   No

Are You a Citizen of the United States? 
Yes   No

Have You Ever Been Convicted of a Felony, State or Federal? 
Yes   No

Driver's License #:   
State:

High School:   
# Years Completed:

College:   
# Years Completed:

Degree Earned:

Beauty/Barber School:

Are You Currently Licensed?  Yes   No

Why Do You Want to Work at Americana?

What Are Your Priorities in This Industry?

What Are Your Long-Term Aspirations?

What Are Your Long-Term Career Goals?

Describe All Special Skills, Qualifications, and/or Training Which You Feel Could Be Useful to You in This Position:

List Your Last Three Consecutive Positions Held; Begin with Present or Last Job:

1. Employer:

Dates / From:   
To:

Address:

Phone:

Position:

Wage / Start:   
End:

2. Employer:

Dates / From:   
To:

Address:

Phone:

Position:

Wage / Start:   
End:

3. Employer:

Dates / From:   
To:

Address:

Phone:

Position:

Wage / Start:   
End:

Personal References:

1. Name:   
Phone:

2. Name:  
Phone:

I certify that the answers given are true and correct to the best of my knowledge. I authorize Americana to verify any representations made by me either oral or written concerning peronal employment, financial and other related matters as may be necessary in arriving at an employment decision. I understand that Americana may contact individuals or organizations other than these I have provided as a refeence in this process. I hereby release all employers, companies, corporations, credit bureaus, law enforcement agencies, schools or persons from any and all liability in responding to inquiries in connection with this application. In the event of employment, I understand that false or misleading information given in this appplication (or any interviews) may result in my discharge. I also understand that the prior written consent of Alericana is required for participating in side ventures or additional employment should I enter into an employment agreement with Americana. In the event of employment, I understand that the employment is entered into voluntarily and I may resign at any time. I also understand that my employment may be terminated for any reason and at any time without previous notice.  PLEASE INITIAL: