Application Form

Personal Information
First Name*
Last Name*
Business Name*
Home Address*
City*
Zip*
Email*
Mobile Telephone*
Professional License Number*
Renewal Date*
MM slash DD slash YYYY
Type of License*
Work History
Present Salon Name
Date Worked From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Are you on salary, commission or rental?*
Other Information
Imagique location Applying For
Desired Suite Number*
Desired Date of Occupancy
MM slash DD slash YYYY
How did you hear about Imagique?
Name of Referral
In The Past Seven Years
Have you been disciplined by any State or Local Agency?
Have you been convicted of or plead guilty to any criminal or felony offense?
Are you presently charged with any felony violations of law?
Have you ever been evicted for any reason from a Landlord?
Have you ever broken a Lease Agreement?
If your answer is YES to any of the preceding questions or any part of the questions, please provide the detail below to include the date, place and nature of each such conviction(s) or pending charge(s). (The existence of a conviction or pending charge will not necessarily preclude you from leasing or employment. The nature of the crime and its relationship to the lease or position applied for, the degree of rehabilitation and the time elapsed since the crime or release from confinement will all be considered.)
Explain
Personal References (aside from family members)
Personal Reference 1 Name*
Address
Phone
Personal Reference 2 Name
Address
Phone
Emergency Contact
Emergency Contact 1 Name*
Address
Phone*
Emergency Contact 2 Name
Address
Phone
Identification Information
Drivers License Number*
Date of Birth
MM slash DD slash YYYY
Untitled
Car (Make, Model, Year, Car color, and License#)*
CAPTCHA
Social Security Number*
Email
This field is for validation purposes and should be left unchanged.

76935

Disclaimer: By filling out this application we have the authorization and permission to run a background check for any applicant

Personal Information

Work History

Other Information

In The Past Seven Years

Personal References (aside from family members)

Emergency Contact

Identification Information