The Spa At Canyon Oaks

First Name: 

Last Name: 

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Address2: 

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Position Applied For: 

Professional Lic #:    Type: 

Date Available: 

Are you legally entitle to work in the USA?  yes  no

Education Background:  List highest level of education completed.  Special schools or training.  Machines or equipment related to this position.

Employment History:  List below your last 3 employers starting with the most recent.

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Employment Dates:  Start       End 

Position Held: 

Duties:
 

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Supervisor:    Phone: 

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Employer's Name: 

Employment Dates:  Start       End 

Position Held: 

Duties:
 

Reason for Departure: 

Supervisor:    Phone: 

May we contact this employer? 

__________________________________

Employer's Name: 

Employment Dates:  Start       End 

Position Held: 

Duties:
 

Reason for Departure: 

Supervisor:    Phone: 

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Background

Have you ever been convicted of a felony crime? 

If so describe: 

Have you been arrested for a felony crime that has not been discharged? 

If so describe: 

I hereby state that all information provided is accurate and may be verified by you. I agree that I may be discharged if The Spa At Canyon Oaks at any time learns of falsification or material omission in the information provided on this application form and related documents. The Spa At Canyon Oaks may contact my former employer in connection with the consideration of my employment with them. All references are hereby authorized to release all information which they may have relevant to my employment with them. I hereby release The Spa At Canyon Oaks, its affiliates, successors, and assigns, and all references from any liability that might be claimed because of information provided by such references.

I agree that I will follow all Company policies, rules, procedures, and all other directions pertaining to my employment. I understand that The Spa At Canyon Oaks reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at any time.

 I agree to the above statement. (required for consideration)   Yes   No