Name *

First Name

Last Name

Phone *

(###)

###

####

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Previous Address (if less than 2 years at current)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Education History

Check all that apply

High School

College/University

Graduate School

Vocational/Technical School

Do You Have an Active Cosmetology or Aesthetics License

No

Yes, Cosmetology

Yes, Aesthetics

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

current employer

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Current employer

In the Past 10 yrs *

Have you been disciplined by any State or Local Agency?

Yes

No

*

Have you been convicted of or plead guilty to any criminal or felony offense?

Yes

No

*

Are you presently charged with any felony violations of law?

Yes

No

Personal Referance *

Please provide 2 references

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

ACKNOWLEDGMENT AND CONSENT STATEMENT

I hereby state that the information given by me in this application is true and correct in all respects. I agree that if I am accepted for leasing and the information is found to be false in any respect, I will be subject to dismissal without notice at any time. I hereby authorize my former employers or salon owners to release information pertaining to my work record, my work habits and my work performance while employed by them. I hereby authorize Lash Narrative to obtain my credit report and conduct a background check. I will read and I hereby agree to be bound by the rules outlined in any procedure manuals, lease documents, rules and regulations publications that I may receive. I agree my electronic signature is the legal equivalent of my manual signature on this application. I understand and agree that, if I am accepted for leasing a lashing station, my lease will be for a duration of at least one year, unless otherwise discussed. By checking the box below I acknowledge that I have read and understand the Consent Statement on this Application.

I Agree to the Terms Above

Date

MM

DD

YYYY