Join Our Team Name * First Last * Last Address * City * State * AL AK AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip code Home Phone Mobile Phone Email * How Did You Hear About Us? * Why Have You Selected to Apply to Mira What Single Strength Do You Possess That Will Be An Asset To The Team? What Position Are You Most Interested In? * Intern Stylist Colorist Massage Therapist Front End Salon Coordination Marketing Management Business Development Are You A Licensed Cosmetologist In Illinois * Yes No I Have No Student Permit When Are You Available To Begin Work * What Type Of Weekly Schedule Are You Seeking * Part Time Full Time Whatever Is Available Would Working Weekends Pose A Problem? If Yes, Why? * Would Working Evenings Pose A Problem? If Yes, Why? Of The Services We Offer, Which Do You Feel Qualified To Perform? Please Indicate If Not Applicable. * Are You A High School Graduate? If Yes, Year Graduated? * Did You Attend A College Or University? If Yes, School Name, Year Graduated And Degree Earned. * Please List Past Employers, Contact Info, Position Held, Responsibilities, Salary, Employment Date And Reason For Leaving. * Are You Currently Employed? If Yes, Can We Contact Employer (Please Provide Contact Info) * Attach A Photo Of Yourself (Optional) Any Additional Information About You Or Comments? Email Δ