We are an Equal Opportunity Employer.

EMPLOYMENT DESIRED:
Position for which you are applying:
Specific Available Hours:
Location/Department:
Salary Required:
Date you can start:
Are you available to work overtime?	Yes   No
Have you ever worked for BAJA BEACH TANNING CLUB?	Yes*   No
*If yes, when?:
*If you answered Yes, which location(s)?:

EDUCATION:
High School:
Name of School
Location of School
# of Years Attended
Did you Graduate	Yes   No
Subjects Studied/Degrees Received
College
Name of School
Location of School
# of Years Attended
Did you Graduate	Yes   No
Subjects Studied/Degrees Received
Post College
Name of School
Location of School
# of Years Attended
Did you Graduate	Yes   No
Subjects Studied/Degrees Received
Trade, Business, Correspondence School
Name of School
Location of School
# of Years Attended
Did you Graduate	Yes   No
Subjects Studied/Degrees Received

GENERAL INFORMATION:

List skills relevant to the postion applied for: Have you ever visited a BAJA BEACH TANNING CLUB location? Describe your experience: What do you like about tanning? Why would you like to work for BAJA BEACH TANNING CLUB? Describe a specific situation where you have provided excellent customer service in your most recent position. Why was this effective?

EMPLOYMENT HISTORY:
Please List your last 3 employers, starting with the most recent:
Most Recent Employer
Name of Employer:
Location:
Dates of Employment:	From to
Salary/Wage:
Position:
Reason for Leaving:
Duties Performed:
Supervisor's Name and Phone Number:
May We Contact?	Yes   No
Previous Employer
Name of Employer:
Location:
Dates of Employment:	From to
Salary/Wage:
Position:
Reason for Leaving:
Duties Performed:
Supervisor's Name and Phone Number:
May We Contact?	Yes   No
Previous Employer
Name of Employer:
Location:
Dates of Employment:	From to
Salary/Wage:
Position:
Reason for Leaving:
Duties Performed:
Supervisor's Name and Phone Number:
May We Contact?	Yes   No

REFERENCES:
Please give the names of three individuals whom you have known for at least one (1) year. NO relatives please.
Name	Occupation/Title	Telephone	Years Known

CERTIFICATION AND SIGNATURE:

I authorize BAJA BEACH TANNING CLUB to thoroughly investigate my background, references, employment record and other matters related to my suitability for employment. I authorize persons, schools, my current employer (if applicable), and previous employers and organizations contacted by BAJA BEACH TANNING CLUB to provide any relevant information regarding my current and/or previous employment and I release all persons, schools, employers of any and all claims for providing such information. I understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up to and including dismissal. I understand that I may be required to sign a confidentiality and/or non-compete agreement should I become an employee of BAJA BEACH TANNING CLUB. I understand that nothing contained in this application, or conveyed during any interview which may be granted, is intended to create an employment contract. I understand that filling out this form does not indicate there is a position open and does not obligate BAJA BEACH TANNING CLUB to hire me. I understand and agree that my employment is at will, which means that is if for no specified period and may be terminated by me or BAJA BEACH TANNING CLUB at any time without prior notice for any reason. Name/Signature:    Date:   9/8/2010