<form action='http://www.40forms.com/fp.aspx' method='post' enctype='multipart/form-data'><input type='hidden' name='mTo' value='matt@mysplish.com'><input type='hidden' name='mSubject' value=''><input type='hidden' name='mSuccessful' value='employmentsuccesspage.html'><table><tr><td valign='top'>First Name</td><td width='10'> </td><td valign='top'><input type='text' name='required:First Name' size='20'></td></tr><tr><td valign='top'>Last Name</td><td width='10'> </td><td valign='top'><input type='text' name='required:Last Name' size='20'></td></tr><tr><td valign='top'>Middle Initial </td><td width='10'> </td><td valign='top'><input type='text' name='Middle Initial ' size='20'></td></tr><tr><td valign='top'>Address 1:</td><td width='10'> </td><td valign='top'><input type='text' name='required:Address 1:' size='20'></td></tr><tr><td valign='top'>Address 2:</td><td width='10'> </td><td valign='top'><input type='text' name='Address 2:' size='20'></td></tr><tr><td valign='top'>City/State Province</td><td width='10'> </td><td valign='top'><input type='text' name='required:City/State Province' size='20'></td></tr><tr><td valign='top'>Zip/Postal Code: </td><td width='10'> </td><td valign='top'><input type='text' name='required:Zip/Postal Code: ' size='20'></td></tr><tr><td valign='top'>Primary Phone: </td><td width='10'> </td><td valign='top'><input type='text' name='required:Primary Phone: ' size='20'></td></tr><tr><td valign='top'>Secondary Phone:</td><td width='10'> </td><td valign='top'><input type='text' name='Secondary Phone:' size='20'></td></tr><tr><td valign='top'>Email: </td><td width='10'> </td><td valign='top'><input type='text' name='required:Email: ' size='20'></td></tr><tr><td valign='top'>Please check which position you are applying for.</td><td width='10'> </td><td valign='top'><input type='checkbox' name='Please check which position you are applying for.' value='Hair Stylist'> Hair Stylist<br><input type='checkbox' name='Please check which position you are applying for.' value='Esthetician'> Esthetician<br><input type='checkbox' name='Please check which position you are applying for.' value='Guest Services Representative'> Guest Services Representative<br></td></tr><tr><td valign='top'>I am interested in </td><td width='10'> </td><td valign='top'><select name='I am interested in '><option value='Full Time'>Full Time</option><option value='Part Time'>Part Time</option></select></td></tr><tr><td valign='top'>Please check days here: </td><td width='10'> </td><td valign='top'><input type='checkbox' name='Please check days here: ' value='Sunday'> Sunday<br><input type='checkbox' name='Please check days here: ' value='Monday'> Monday<br><input type='checkbox' name='Please check days here: ' value='Tuesday '> Tuesday <br><input type='checkbox' name='Please check days here: ' value='Wednesday'> Wednesday<br><input type='checkbox' name='Please check days here: ' value='Thursday '> Thursday <br><input type='checkbox' name='Please check days here: ' value='Friday'> Friday<br><input type='checkbox' name='Please check days here: ' value='Saturday'> Saturday<br></td></tr><tr><td valign='top'>Have you ever been convicted of or charged with a felony or misdemenaor?</td><td width='10'> </td><td valign='top'><select name='Have you ever been convicted of or charged with a felony or misdemenaor?'><option value='Yes'>Yes</option><option value='No'>No</option></select></td></tr><tr><td valign='top'>If your resome and referrances are on file. Please upload them here.</td><td width='10'> </td><td valign='top'><input type='file' name='If your resome and referrances are on file. Please upload them here.'><input type='hidden' name='filetypes' value='.pdf,.doc,.gif,.jpg'></td></tr><tr><td valign='top'>Provide employment history. If you do not have any experience click here:   For each item of Work Experience, enter your responses in the spaces provided, then click “Add This Entry” to save your changes. You can add as many entries as needed.</td><td width='10'> </td><td valign='top'><input type='checkbox' name='Provide employment history. If you do not have any experience click here:   For each item of Work Experience, enter your responses in the spaces provided, then click “Add This Entry” to save your changes. You can add as many entries as needed.' value=''> <br></td></tr><tr><td valign='top'>Employer Name:</td><td width='10'> </td><td valign='top'><input type='text' name='Employer Name:' size='20'></td></tr><tr><td valign='top'>Position Title</td><td width='10'> </td><td valign='top'><input type='text' name='Position Title' size='20'></td></tr><tr><td valign='top'>Supervisor Name</td><td width='10'> </td><td valign='top'><input type='text' name='Supervisor Name' size='20'></td></tr><tr><td valign='top'>Start Date</td><td width='10'> </td><td valign='top'><input type='text' name='Start Date' size='20'></td></tr><tr><td valign='top'>End Date</td><td width='10'> </td><td valign='top'><input type='text' name='End Date' size='20'></td></tr><tr><td valign='top'>Address 1:</td><td width='10'> </td><td valign='top'><input type='text' name='Address 1:' size='20'></td></tr><tr><td valign='top'>Address 2:</td><td width='10'> </td><td valign='top'><input type='text' name='Address 2:' size='20'></td></tr><tr><td valign='top'>City</td><td width='10'> </td><td valign='top'><input type='text' name='City' size='20'></td></tr><tr><td valign='top'>State</td><td width='10'> </td><td valign='top'><input type='text' name='State' size='20'></td></tr><tr><td valign='top'>Zip</td><td width='10'> </td><td valign='top'><input type='text' name='Zip' size='20'></td></tr><tr><td valign='top'>School Name</td><td width='10'> </td><td valign='top'><input type='text' name='School Name' size='20'></td></tr><tr><td valign='top'>Type of Degree </td><td width='10'> </td><td valign='top'><input type='text' name='Type of Degree ' size='20'></td></tr><tr><td valign='top'>Was Degree Earned?</td><td width='10'> </td><td valign='top'><input type='checkbox' name='Was Degree Earned?' value='Yes'> Yes<br><input type='checkbox' name='Was Degree Earned?' value='No'> No<br></td></tr><tr><td valign='top'>Last Year Of School</td><td width='10'> </td><td valign='top'><input type='text' name='Last Year Of School' size='20'></td></tr><tr><td valign='top'>Reference Name</td><td width='10'> </td><td valign='top'><input type='text' name='Reference Name' size='20'></td></tr><tr><td valign='top'>Phone</td><td width='10'> </td><td valign='top'><input type='text' name='Phone' size='20'></td></tr><tr><td valign='top'>Relationship</td><td width='10'> </td><td valign='top'><input type='text' name='Relationship' size='20'></td></tr><tr><td valign='top'>Comment</td><td width='10'> </td><td valign='top'><textarea name='Comment' cols='20' rows='3'></textarea></td></tr><tr><td colspan='3' align='center'><input type='submit' value='Submit'>    <input type='reset' value='Reset'></td></tr></table></form>