Today's Date*
PERSONAL INFORMATION
Your Name First and Last*
Your Address*
Your City*
Your State* Illinois - ILAlabama - ALAlaska - AKArizona - AZArkansas - ARCalifornia - CAColorado - COConnecticut - CTDelaware - DEFlorida - FLGeorgia - GAHawaii - HIIdaho - IDIndiana - INIowa - IAKansas - KSKentucky - KYLouisiana - LAMaine - MEMaryland - MDMassachusetts - MAMichigan - MIMinnesota - MNMississippi - MSMissouri - MOMontana - MTNebraska - NENevada - NVNew Hampshire - NHNew Jersey - NJNew Mexico - NMNew York - NYNorth Carolina - NCNorth Dakota - NDOhio - OHOklahoma - OKOregon - ORPennsylvania - PARhode Island - RISouth Carolina - SCSouth Dakota - SDTennessee - TNTexas - TXUtah - UTVermont - VTVirginia - VAWashington - WAWest Virginia - WVWisconsin - WIWyoming - WY
Your Zip Code*
Your Mobile Number*
Your Email*
IL Beauty License #*:
MARKETING
How did you hear about us?* IndeedFacebookInstagramReferralOtherIndeed
If Referral, Who?
OBJECTIVE
What is prompting you to inquire about Booth Rental at Premier?*
Are you legally eligible to work in the United States?* YESNO
Current Work Situation:
What is your current work situation?* Self-EmployedEmployee
Do you currently have an established client base that will follow you?* YESNO
How many years have you been in the industry?*
AVAILABILITY
What date would you be ready to start renting?*
Days and Hours Interested in:*
Our staffed hours are Tuesday-Thursday 9am-9pm, Fridays 9am-5pm, Saturdays 9am-6pm, and Sundays 9am-5pm.
Please be specific. On days you want off just specify off.
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
Your Online Presence:
Professional Instagram:
Professional Facebook:
Website Address:
Business Credentials:
Do you currently have professional liability insurance?* YESNO
Do you currently have a Federal Tax ID number?* YESNO
Do you currently have a merchant account?* YESNO
If yes, which company is it with?
REFERENCES
Please list three persons, who are not related to you or previous supervisors, who can provide professional references.
Name(First and Last)
Phone Number
Occupation
Years Known
Your Name First and Last as your digital signature*
