Work for Dr. Shel Wellness & Aesthetic Center in Sugar Land

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PERSONAL DATA

Name*
Address*
This information will be used only for child labor law purposes
Are there any days, shifts or hours you will not work?
Have you taken any illegal drugs in the last 30 days?
Are you legally authorized to work in the United States?
Note: The Federal Immigration and Reform and Control Act of 1986 requires that a DHS Employment Eligibility Verification "FORM I-9" be completed for every new hire and that within 3 business days of beginning work every new hire must present to the employer documentation establishing his/her identity and authorization to work. This federal requirement must be satisfied as a condition of employment.

DRIVING RECORD

(Answer only if driving is a requirement of the job for which you are applying)

RESIDENCES

(Part 391.21 (b)(3))(Please provide your addresses of residence for the past seven years beginning with the most recent address.)
Address*

EDUCATION

(May or may not be considered depending on job applied for.) Describe any educational degrees, skill, training or experience you believe are relevant to the job applied for:
Graduated
Graduated

EMPLOYMENT HISTORY

(Please complete for all full-time or part-time employment beginning with most recent employer. You may include as part of your employment history any verified work performed on a volunteer basis)
Address*
May we contact

REFERENCES

(Please list three persons not related to you who know your qualifications.)
Address*
Address*
Have you ever been discharged or forced to resign?
Have you signed any non-compete or non-solicit agreement with any other employer that might restrict you from working for this company?
(You may be required to furnish a copy of the agreement)

LIE DETECTOR TESTS

Massachusetts Applicants Note: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Maryland Applicants Only: An employer may not require or demand, as a condition of prospective employment or continued employment, an individual submit to or take a lie detector or similar tests. An employer who violates this law is guilty of a misdemeanor and subject to a fine not exceeding $100. I have read and acknowledge this notice:

CRIMINAL RECORD INFORMATION

1. Have you been convicted of a felony within the last seven years?
2. Have you been convicted within the last seven years of misappropriation of funds, embezzlement, or similar for other dishonest conduct; or an offense involving the use of a weapon; for burglary, robbery, breaking and entering or theft; or physical assault or other violent crime?
3. Have you been convicted of or completed a period of incarceration within the past five years for any misdemeanor?
4. A criminal conviction will not necessarily be a bar to employment. To help us evaluate your application, please describe your criminal conviction(s) including penalty (ies) imposed, listing the nature of your offense(s), and your rehabilitation
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