26/52 WEEK STUDIO LEASE APPLICATION

Check the Location for Apply:Image Salon Studios : Sugar LandImage Salons 2 : Sugar LandImage Salons Royal Oaks : Houston

Basic Information:

First Name:

Last Name: *

Middle Name:

Street:*

City: *

State:*

Zip: *

Phone:

Cell:

Date of Birth: *

Email: *

Social Security #: *

Driver's License #:*

Cosmetology License #:

Referred By:

Provider Type:

Business Name:

Federal Tax ID No.

Please list any other licenses you may have (salon license, mini salon license, booth rental license, barber license, barbershop license, mini barbershop license, etc)

Desired lease date:

Desired suite size:

Desired suite location (ex. front, window, corner, back, etc):

What's your current gross weekly income derived from your clientele? $

What is the number of clients you currently service?

Work History:

Company/Salon Name :

Supervisor :

Phone :

May we contact? :

Address :

Dates Employed:

From:

To:

What is your annual salary? :

Booth rent or commission? :

Weekly booth rent :

Commission pay :

Company/Salon Name :

Supervisor :

Phone :

May we contact? :

Address :

Dates Employed:

From:

To:

What is your annual salary? :

Booth rent or commission? :

Weekly booth rent :

Commission pay :

Company/Salon Name :

Supervisor :

Phone :

May we contact? :

Address :

Dates Employed:

From:

To:

What is your annual salary? :

Booth rent or commission? :

Weekly booth rent :

Commission pay :

Emergency Contact Information:

Name*

Phone Number*

Relationship to Applicant*

In the past seven years:

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

YesNo

Have you been released from confinement following a conviction for any criminal felony offences?

YesNo

Are you presently charged with any felony violations of law?

YesNo

If your response to any of the preceding three questions was YES, give the date, place and nature of each such conviction or pending charge. (The existence of a conviction or pending charge will not necessarily preclude you from contracting service. The nature of the crime and its relationship to the position applied for, the degree of rehabilitation and the time elapsed since the crime or release form confinement will all be considered)

(Explain)

Professional References

Name:

Phone (hm)

(Cell)

City

State:

Zip:

Name:

Phone (hm)

(Cell)

City

State:

Zip:

ACKNOWLEDGEMENT AND CONSENT STATEMENT

I hereby state that the information given by me in this application is true in all respects. I hereby authorize my former employers, and professional references to release information pertaining to my work record, my work ethics, and my personal character. I will read and abide by the rental contract, rules, and any procedures that I may receive.

I acknowledge that an investigative/background check will be used in the approval process.

First Name:*

Last Name:*

26/52 WEEK STUDIO LEASE APPLICATION

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