Employment Application

Rolfs Corporate
14269 N 87th Street
Suite 201
Scottsdale, AZ 85260
www.rolfssalon.com
Employment Application
We are an Equal Opportunity/Reasonable Accommodation Employer
• Print neatly in ink or type.
• Read all information on this application.
• Answer all questions completely.
• Sign this application and all other forms.
POSITION DESIRED
Please check the shift(s) you are interested in:
Full Time
Part Time
Rotation (all shifts)
Nights
Temporary
Weekends
Position Applied For:
Application Date:
Salary Requirements:
PERSONAL DATA
Last Name:
First Name:
MI:
Street Address:
City:
State:
Home Telephone:
Zip:
Mobile/Alternate Telephone:
E-Mail Address:
Are you legally eligible for employment in the United States?
Are you 18 years of age or older?
YES
Have you ever been employed by Rolfs?
Are any of your relatives employed by Rolfs?
NO
YES
If YES, please provide: Employee’s Name:
If YES, please provide dates:
NO
Relationship:
State:
Driver’s License Number:
NO
If NO, please provide age:
NO
YES
YES
Location:
Class:
Have you ever been discharged, requested, or forced to resign from any previous position?
YES
NO
If YES, please explain the circumstances:
Have you ever been convicted of a felony?
YES
NO
If YES, please explain:
Please list other names you have used:
When will you be available to begin work?
What hours are you available to work?
SALON POLICIES
Shifts are scheduled between 6:30 a.m. and 10:00 p.m. We ask all employees to arrive at work at or before their
scheduled start time. Are your able to arrive at or before your scheduled start time?
YES
NO
If NO, please explain:
We ask all employees to be available to work weekends. Are you available to work weekends?
YES
NO
If NO, please explain:
Except in the event of an emergency, are you able to refrain from making personal calls during work hours?
YES
NO
If NO, please explain:
Are you available to attend training sessions that may occur outside your normal work hours?
YES
/aud
NO
If NO, please explain:
Revised: 07/12/11
Employment Application
Page 2
EDUCATION
YES
High School Diploma:
G.E.D.:
YES
NO
If NO, please indicate highest level completed:
NO
Do you hold a current Arizona State Cosmetology License?
YES
Major
College/University
NO
Credit Hours
Degree*
*If applicable to position, proof of degree from College/University will be required upon hire.
Special Training (Institution, Business, Tech, Other)
Course of Study
Diploma/Hours Completed
Date
Please list any professional licenses, registrations, certificates and memberships including license number and date:
Please list any honors, awards or fellowships:
SKILLS
Approximate typing speed in words per minute (wpm):
Please list computer software with which you are familiar:
Fluent in a language other than English?
Language:
Speak:
Read:
Write:
Please summarize relevant skills, abilities and experience that exemplify your qualifications for the position:
Summarize community service work (paid or volunteer) including dates:
Employment Application
Page 3
EMPLOYMENT HISTORY (you may attach a resumé, but please do not use as a substitute for completing application)
Employer:
Telephone:
Street Address:
City:
State:
Your Title:
No. of workers you directly supervised:
Employment Dates:
From:
To:
Supervisor’s Name/Title:
Starting Salary:
Zip:
May we contact?
Ending Salary:
YES
NO
Hours per week:
Work Performed:
Reason for leaving or wanting to change:
Employer:
Telephone:
Street Address:
City:
State:
Your Title:
No. of workers you directly supervised:
Employment Dates:
From:
To:
Supervisor’s Name/Title:
Starting Salary:
Zip:
May we contact?
Ending Salary:
YES
NO
Hours per week:
Work Performed:
Reason for leaving or wanting to change:
Employer:
Telephone:
Street Address:
City:
State:
Your Title:
No. of workers you directly supervised:
Employment Dates:
From:
To:
May we contact?
Supervisor’s Name/Title:
Starting Salary:
Work Performed:
Reason for leaving or wanting to change:
Zip:
Ending Salary:
YES
Hours per week:
NO
Employment Application
Page 4
REFERENCES
Please provide three references in the space below.
References should be individuals not related to you whom you have known for at least one year.
Reference Name
Telephone No.
Relationship
Years Known
CONDITIONS OF CONSIDERATION FOR EMPLOYMENT
All information contained on the application is subject to verification. Rolfs may conduct background checks including, but not limited to,
work references, driving records, criminal conviction records and educational attainment.
I understand an employment offer from Rolfs may be contingent upon successful completion of a pre-employment alcohol/drug test, if
requested by Rolfs. I further understand that any condition which may preclude my ability to perform functions of the job - and such
conditions cannot be reasonably accommodated - will disqualify me from consideration for employment in the job for which I was considered.
I understand that an employment offer from Rolfs may also be contingent upon successful completion of a background investigation.
I understand that employment at Rolfs is “at will” meaning that it may be terminated at any time by either party.
I understand that all conditions of employment including, but not limited to, hours, benefits and salary are subject to change by Rolfs at any
time.
If employed, I agree to provide proof of identity, relevant licensure or credentials, and authorization for employment in the United States.
If employed, I agree to abide by all policies, regulations and guidelines established by Rolfs.
I certify that all the information provided herein is true and complete to the best of my knowledge. I agree and understand that
omissions, misstatements, and falsifications will cause forfeiture on my part of all eligibility to any employment with Rolf’s and may
be cause for rejection of this application, or discharge from service. In addition, I give Rolfs the right to investigate and verify any
information obtained through the application process. Permission is granted and I release from any and all liability any employer,
agency or individual assisting Rolfs in providing relevant, job related information that will assist in this process. My signature below
acknowledges my understanding and agreement with the above.
Rolfs promotes a drug and alcohol-free workplace.
Signature:
Date:
TO ALL APPLICANTS
EQUAL EMPLOYMENT OPPORTUNITY SURVEY
This information will be used for notification purposes only.
Instructions: Please print clearly in each category below.
Last Name:
First Name:
MI:
Street Address:
City:
State:
Home Telephone:
Zip:
Mobile/Alternate Telephone:
E-Mail Address:
Position Applied For:
The following information is being collected by Rolfs’ Human Resources office for research and federal equal employment opportunity
requirements only. Your responses are strictly voluntary and will help in monitoring our affirmative action efforts. If you choose not to
answer any of the items, you will not be subject to any adverse effects. However, we urge you to do so and assure you that this form
is confidential. It will be separated from your application prior to referral to any hiring manager.
Indicate your choice of responses for items A through F by placing an X in the appropriate box. If you do not wish to answer the item,
please mark the “No response” box.
A.
B.
ETHNIC CATEGORY:
Check only one category
WHITE
AFRICAN AMERICAN/BLACK
HISPANIC
ASIAN OR PACIFIC ISLANDER
AMERICAN INDIAN OR ALASKAN NATIVE
NO RESPONSE
MALE
FEMALE
SEX
NO RESPONSE
C.
AGE GROUP
UNDER 20
20-29
30-39
40-49
50-59
60-69
NO RESPONSE
D.
VETERAN STATUS
I AM a Veteran of the U.S. Armed Forces, honorably separated following more than 180 days of active duty.
I AM NOT a Veteran
I am a SPOUSE of a PERMANENTLY DISABLED VETERAN
I am a SPOUSE of an Active Duty Armed Forced Member who is MISSING IN ACTION
NO RESPONSE
E.
ARE YOU DISABLED?
YES
NO
NO RESPONSE
F.
HOW DID YOU LEARN OF THIS POSITION?
Signature:
/aud
JOB BULLETIN
NEWSPAPER
JOB LINE
REFERRAL AGENCY
OTHER INTERNET SITE
OTHER
ROLF’S WEBSITE
JOB/CAREER FAIR
NO RESPONSE
Date:
Revised: 07/12/11