Job Application Personal InformationName* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneMobile PhoneEmail Address* Position applied for:* How did you learn about the position? Are you available to work:* Full Time Part Time Daytime Evening If you are offered employment, what date would you be available to begin work?*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Have you ever been convicted of, entered a guilty plea or nolo contendere to a crime?* Yes No If yes, please explain*Volunteer Activities (list organization, type of service, dates):Hobbies, Sports, Interests:EducationHigh School / CollegeName of SchoolCity and StateDates AttendedDate of Graduation Personal ReferencesProvide 3 references that are not family membersName* Years Known* Phone Number*Name* Years Known* Phone Number*Name* Years Known* Phone Number*Skills and KnowledgeCheck next to the skills/knowledge that you have. Enter the number of years of experience and mark the column of your proficiency level. List any other skills/knowledge that may be useful for the position that you are seeking. Skills/Knowledge* Filing Customer Service Experience Answering Phones Cash Handling Computers (MS Windows OS) Email Document Editors (MS Word, Google Docs, Etc.) Internet Browsers (Chrome, Firefox, MS Edge, Etc.) Database/Data Entry Other? Years of Experience (Filing)* Proficiency (Filing)* Excellent Good Fair Years of Experience (Customer Service Experience)* Proficiency (Customer Service Experience)* Excellent Good Fair Years of Experience (Answering Phones)* Proficiency (Answering Phones)* Excellent Good Fair Years of Experience (Cash Handling)* Proficiency (Cash Handling)* Excellent Good Fair Years of Experience (Computers)* Proficiency (Computers)* Excellent Good Fair Years of Experience (Email)* Proficiency (Email)* Excellent Good Fair Years of Experience (Document Editors)* Proficiency (Document Editors)* Excellent Good Fair Years of Experience (Internet Browsers)* Proficiency (Internet Browsers)* Excellent Good Fair Years of Experience (Database/Data Entry)* Proficiency (Database/Data Entry)* Excellent Good Fair Other Skills? Please describe.*Employment Experience(Start with your most recent employer)1.Employer Date Employed Until Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneSupervisor Your Job Title Reason for Leaving Starting Hourly Rate/Salary Final Hourly Rate/Salary 2.Employer Date Employed Until Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneSupervisor Your Job Title Reason for Leaving Starting Hourly Rate/Salary Final Hourly Rate/Salary 3.Employer Date Employed Until Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneSupervisor Your Job Title Reason for Leaving Starting Hourly Rate/Salary Final Hourly Rate/Salary ResumePlease upload your resume in Word or PDF formatMax. file size: 200 MB.I certify that all information provided in this employment application is true and complete. I authorize Alpha School of Massage, Inc. to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding myself. I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.* I agree. NameThis field is for validation purposes and should be left unchanged.