Application for Employment
PERSONAL INFORMATION
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Position applying for (Front desk / RN / NP / Esthetician / Other)
*
Date Available to Start
*
-
Month
-
Day
Year
Date
Desired Schedule(full-time, part-time, weekends, etc.)
*
HIGH SCHOOL INFORMATION
School Name
City/State
Years Attended (From-To)
Graduated?
Yes
No
Diploma/Certificate
*
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COLLEGE INFORMATION
College/University name
City/State
Degree/Major
Years attended (From – To)
Graduated?
Yes
No
VOCATIONAL/TRADE/OTHER TRAINING
School/Program name
Type of training (Esthetics, Nursing, Medical Assistant, etc.)
License or certification number (if applicable)
State of license
Years attended (From – To)
Completed?
Yes
No
WORK EXPERIENCE
Work Experience
*
PROFESSIONAL LICENSES AND CERTIFICATIONS
License type (RN, LPN, Esthetician, etc.)
License number
State
Date
-
Month
-
Day
Year
Date
Other certifications (BLS, ACLS, laser, injectables, etc.)
REFERENCES
Reference
*
UPLOADS
Upload resume (PDF or Word)
*
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Upload cover letter (optional)
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Upload Profile Picture (JPEG/PNG)
*
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ADDITIONAL INFORMATION
Why do you want to work at Kauai Medspa?
What days and times are you available?
Any other information we should know?
*
I certify that the information provided is true and complete.
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
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