Name____________________________________ Phone #________________ Are you on Facebook?____________

Email____________________________________________________________________________________________

Past Work Experience:

Employer___________________________________________ Dates Employed From_____________To_____________

Job Title______________________________Reason for Leaving_____________________________________________

Work duties performed_______________________________________________________________________________

Employer___________________________________________ Dates Employed From_____________To_____________

Job Title______________________________Reason for Leaving_____________________________________________

Work duties performed_______________________________________________________________________________

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About You:

Tell us about your competitive spirit:____________________________________________________________________

_________________________________________________________________________________________________

What are you personal dreams? Goals?_________________________________________________________________

_________________________________________________________________________________________________

Are you willing to travel for training?__________ Do you consider yourself teachable/trainable?_____________________

Are you highly motivated?________________ If yes, what motivates you?______________________________________

Do you currently hold any licenses i.e.: cosmetology, masseuse, etc.? _________________________________________

_________________________________________________________________________________________________

Education: ________________________________________________________________________________________

_________________________________________________________________________________________________

Please attach your resume and list of references.

Date:____________________________________________                        Position Applying for:_______________________________

435 1/2 South Auburn Street

Grass Valley CA 95945

Email: HR@m3mall.biz

Become a fan on Facebook: www.facebook.com/m3mall

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