General Information

Name:

Address:

City:

State:

Zip:

Are you 18 yrs or older?

Yes

No

Home Phone:

E-Mail:

Full Time

Part Time

For Part Time, Total Hours Available Per Week

Date Ready to Start:

Do you have reliable transportation to work?

Yes

No

Education and Training

High School:		Graduation Date:
Secondary Schools (College, Graduate, Technical, etc)
School 1:		Graduation Date:
School 2:		Graduation Date:
School 3:		Graduation Date:

Work Experience

List your previous jobs. Begin with your most recent position. Account for periods of unemployment.

Company:

Address:

City:		State:	Zip:
Job Title:		Supervisor:

Phone:

May We Contact?

Yes

No

Dates Employed:

to

Start Pay

End Pay

Times Absent

/Year

Reason for Leaving:

Company:

Address:

City:		State:	Zip:
Job Title:		Supervisor:

Phone:

May We Contact?

Yes

No

Dates Employed:

to

Start Pay

End Pay

Times Absent

/Year

Reason for Leaving:

Company:

Address:

City:		State:	Zip:
Job Title:		Supervisor:

Phone:

May We Contact?

Yes

No

Dates Employed:

to

Start Pay

End Pay

Times Absent

/Year

Reason for Leaving:

Additional Info

Have you previously been employed by Planet Sun?

NO  YES

If yes:  Where

When:

Please tell us about your tanning experience:

In Case Of Emergency Notify:
Address:

Phone:

Our attendance policy does not tolerate frequent tardiness or absences. Do you know of any reason that you may not be able to comply with the Company's attendance policy?

NO  YES

If YES, explain:

Have you ever been dismissed or forced to resign from any employment?	NO  YES
If YES, explain:
Have you been convicted of a felony crime or theft-related misdemeanor within the last ten years? - include all misdemeanor/felony convictions including under the influence of intoxicants. Convictions will not necessarily disqualify applicant as each case is considered individually.	NO  YES
If YES, give date, nature of offense(s) and where convicted*:

Date:

Nature of Offense(s):

City:

State:

Read Below Before Submitting Application

I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification and/or omission of this information may result in dismissal in accordance with company policy. I agree to indemnify, defend and hold harmless, and release Planet Sun (the "Company") from and against any and all losses, damages, liabilities, and lawsuits of every nature that may result from falsification and/or omission of the information. The Company in considering my application for employment may verify the information set forth on this application and obtain additional information relating to my background. I authorize all persons, schools, companies, corporations, credit bureaus and law enforcement agencies to supply any information concerning my background, and release all parties from all liability and for any damage that may result from furnishing same to the Company. I realize that benefits, policies, or programs are provided at company discretion and may be changed or eliminated at any time. In consideration of employment, I agree to conform to the rules and regulations of the Company, I agree to enter into non-competition, non-solicitation, and non-disclosure agreements with the Company. I agree that upon any job-related accident, within 3 hours of the accident, I will be drug tested at a company-approved facility. I understand that as part of the processing procedure for my employment application an investigative background report may be requested. Upon written request within a reasonable period of time, a complete and accurate disclosure concerning the nature and scope of the investigation may be furnished to me. I agree to take a drug test at any time, at the discretion of the company. I further agree that should circumstance arise, I will submit to a polygraph test in accordance with state and federal laws. This application will remain active until my separation. I understand and agree that when my employment is terminated by retirement or otherwise, I must return all of the Company's property in my custody, including but not limited to office keys, manuals, sales materials, lists, etc., and that any amounts due and owing to the company by me must be paid in full before I am entitled to final payment of any amounts due me or to anyone on my behalf upon separation. Further, I voluntarily agree to and authorize the company to deduct any monies owed to the company from my wages, which may be due as a result of overpayment of wages, loss or destruction of property or any other amounts which I may owe, or for which I have received full consideration, and to pay off any amount owing to the company in full prior to receiving final payment of any amounts due me upon separation. If any part of this application is finally held to be invalid or unenforceable, I agree that part shall be stricken from this application, as if it never had been contained herein. Such invalidity or unenforceability shall not extend to or otherwise affect any other part of this application, and the unaffected parts hereof shall remain in full force and effect to the fullest extent permitted by law. In accepting employment, I acknowledge that the policies, benefits, and other programs listed in company booklet and policy manuals do not infer or imply a contract of employment between the company and myself, that this application is not an employment contract, and that I am an employee at will. I realize that I am an employee-at-will, and that my employment and compensation can be terminated, with or without notice, with or without cause, at any time, at the option of either the company or myself. I understand that no company representative has any authority to enter into any agreement to employ me for any specified period of time or to make any agreement contrary to the foregoing. I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE AND FULLY UNDERSTAND THE DOCUMENT I AM SIGNING.

I Agree