Application for Employment

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Kinder Krowns, LLC.
7505 Highway 7, Suite 100
St. Louis Park, MN 55426

Name *

Last, First, Middle, Maiden

Present Address *

Permanent Address *

Telephone *

Position applied for *

Date you can start? *

Are you employed now? *

Yes

If so, may we contact your current employer?

Yes

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Have you ever applied to this company before? *

Yes

If yes, where and when.

Educational History *

Please list all educational history, including a list of schools attended (name + address), # of years completed, and any major/degree.

Work Experience *

Please provide a list of work experience from most recent to least recent for the last 5 years. Please include employer address, name of supervisor, dates of employment, salary, title, and reason for leaving.

References *

Please list two references other than relatives or friends. (Name, Phone, Email and Address)

Additional Information

Please summarize any additional information necessary to describe your qualifications for the specific position you are applying for.

Have you ever been convicted of a crime? *

Yes

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Signature (Initials) i.e. John Denver Doe = JDD *

By initialing this online application, I certify the information provided is truthful and accurate.

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By clicking submit I understand that Mayclin Dental Studio, Inc. is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring promotion, transfer, and compensation to all qualified applicants and employees without regard to age, race, color, national origin, sex, religion, handicap or disability, and any other category protected by federal, state, or local law.

I authorize former and present employers, and professional work, and personal references listed in the application and any other individuals. I may name to give Mayclin Dental Studio, Inc. or its designee any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release such parties from all liability for any damages that may result from furnishing same to Mayclin Studio, Inc. I also authorize Mayclin Dental Studio, Inc. to provide truthful information concerning my employment with it to future employers, and I agree to release Mayclin Dental Studio, Inc. from all liability for providing such information.

I understand that Mayclin Dental Studio, Inc. reserves the right, to the extent permitted by law, to require drug and alcohol screening tests of any applicant or an employee either prior to employment or any time during employment, and I hereby give my consent to any such tests. I consent to the release of the results of any such tests to Mayclin Dental Studio, Inc. or its designee. I release Mayclin Dental Studio, Inc. and its designee from any and all liability and damages that my result or arise from any drug test or the provision of information in connection with such a test.

I understand that this employment application and any other Mayclin Dental Studio, Inc. documents are not promises of employment. Should I be employed, I understand that my employment will be for a trial period for ninety (90) days from the date of my hiring and that I will remain an at-will employee thereafter. I further understand that, if I am employed, I can terminate my employment at any time with or without cause and with or without advance notice and that Mayclin Dental Studio, Inc. has a similar right. I understand that no manager, representative, or agent of Mayclin Dental Studio, Inc. has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except that the President may do so in writing.

The information provided by me on the application and during the interview process is true and complete in all respects, and I agree that if the information is found to be false, misleading, or unsatisfactory in any respect (Mayclin Dental Studio, Inc.’s judgment) that I will be disqualified from consideration for employment or subject to immediate dismissal if this is discovered after I am hired.

I CERTIFY THAT I HAVE RECEIVED A SEPARATE WRITTEN NOTIFICATION THAT MAYCLIN DENTAL STUDIO, INC. MAY OBTAIN A CONSUMER REPORT ON ME FOR USE IN CONNECTION WITH MY APPLICATION AND, IF I AM HIRED, MY EMPLOYMENT WITH MAYCLIN DENTAL STUDIO, INC. I AUTHORIZE MAYCLIN DENTAL STUDIO, INC. TO OBTAIN THIS REPORT.

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