Question : Classic ASP form to email sending empty email?

Hello, been scratching my head for a while now on this one. Hope I'm just missing something simple here.

Every time I submit this form it sends one email correctly but follows it up with an email that has all the layout text for the body but no variable values?? How can I fix it to stop sending the 2nd useless email?

TIA,
Andrew 
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<html>

<head>
<meta content="IE=EmulateIE7" http-equiv="X-UA-Compatible">
<meta content="General" name="rating">
<meta content="EN-US" name="MS.LOCALE">
<meta content="index,follow" name="robots">
<meta content="http://www.massageluxe.com" name="URL">
<meta content="31 days" name="revisit-after">
<meta content="TRUE" name="MSSmartTagsPreventParsing">
<meta content="MassageLuxe" name="Title">
<meta content="Our mission at MassageLuxe is to deliver the highest quality massage by providing a comfortable, relaxing, and luxurious environment to all of our clients. MassageLuxe offers many different types of massage." name="description">
<meta content="massage, massage therapy, couples massage, massage membership, swedish massage, deep tissue, relaxation, gift cards, massageluxe, relax, membership, members" name="keywords">
<title>Massageluxe - Application Page 1</title>
<link href="favicon.ico" rel="shortcut icon">
<link href="css/style.css" rel="stylesheet" type="text/css">
<link href="favicon.ico" rel="shortcut icon">
<script type="text/javascript"> 
function validate(form) { 
if (document.form1.EmailAddress.value == "")
	{
	alert("Please enter a valid EMAIL ADDRESS. A copy of this application will be forwarded to it upon submission of this form for your records."); 
	return false; 
	}
else if (!document.form1.Agree.checked)
	{
	alert("Please check the terms and conditions"); 
	return false; 
	}
else if (document.form1.Name.value == "")
	{
	alert("Please digitally sign for the terms and conditons"); 
	return false; 
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else
	{
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}
</script>
<style type="text/css">
.style18 {
	background-image: url('images/ML-Banner.jpg');
	text-align: center;
}
.style19 {
	background-image: url('images/Navigation/Careers-Nav.jpg');
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	color: #2A7782;
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.style49 {
	background-image: url('images/Body Misc/app_background.jpg');
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#table19 {
	margin-left: 0px;
}
#table27 {
}
#table43 {
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#table35 {
}
.style59 {
	color: #FF0000;
	font-size: 14pt;
}
.style60 {
	font-weight: bold;
	text-align: justify;
}
</style>
</head>

<body style="margin: 0px; font-family: Arial, Helvetica, sans-serif;">

<div align="center">
	<font face="Georgia">
	<div align="center">
		<table id="table1" border="0" cellpadding="0" cellspacing="0" width="827px">
			<tr>
				<td class="style18" style="height: 140px;" valign="top">
				<a href="default.htm">
				<img alt="MassageLuxe" class="style40" height="135px" src="images/clrBanner.gif" width="815px"></a></td>
			</tr>
			<tr>
				<td class="style19" style="height: 4;">
				<map id="FPMap1" name="FPMap1">
				<area coords="714, 4, 826, 33" href="Franchise.htm" shape="rect">
				<area coords="509, 4, 593, 33" href="Careers.htm" shape="rect">
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				</map>
				<img alt="MassageLuxe" class="style54" height="39px" src="images/ClearMenu.gif" usemap="#FPMap1" width="827px"></td>
			</tr>
		</table>
	</div>
	</font></div>
<form action="application_thankyou.asp" method="post" name="form1" onsubmit="return validate(this)">
	<table id="table2" align="center" cellpadding="0" cellspacing="0" style="width: 827px;">
		<tr>
			<td valign="top">
			<table align="left" cellpadding="0" cellspacing="" class="style49" style="width: 827px;">
				<tr>
					<td class="style44" style="height: 375px" valign="top">
					<table id="table12" border="0" cellpadding="0" cellspacing="0" width="645">
						<tr>
							<td rowspan="2" style="width: 45px"><b>&nbsp;</b></td>
							<td height="5" nowrap valign="TOP">
							<table id="table13" border="0" cellpadding="0" cellspacing="0" width="554">
								<tr>
									<td class="style58" style="height: 60px" width="">
									Employment Application</td>
								</tr>
								<tr>
									<td class="style57" width="">Equal access to 
									programs, services and employment is available 
									to all persons. Those applicants requiring reasonable 
									accommodation to the application and / or interview 
									process should notify a representative of the 
									Human Resources Department. </td>
								</tr>
							</table>
							<b><font size="1"><br></font><font size="2">Location 
							applied for</font> </b></td>
						</tr>
						<tr>
							<td nowrap valign="TOP" width="387">
							<table id="table14" border="0" cellpadding="0" cellspacing="0" width="500">
								<tr>
									<td style="height: 15px">
									<font face="Tahoma">
									<select class="style56" name="LocationsApplied" size="1" style="height: 22px">
									<option selected="">...</option>
									<option>Brenneman Farm, VA</option>
									<option>Brentwood, MO</option>
									<option>Chesterfield, MO</option>
									<option>Creve Coeur, MO</option>
									<option>Kirkwood, MO</option>
									<option>La Promenade, VA</option>
									<option>Osage Beach, MO</option>
									<option>Rock Hill, MO</option>
									</select></font> </td>
								</tr>
								<tr>
									<td height="15"><b><font size="2">Position applied 
									for</font> </b></td>
								</tr>
								<tr>
									<td><font face="Tahoma">
									<select class="style56" name="Positions" size="1">
									<option selected="">...</option>
									<option>Massage Therapist</option>
									<option>Sales Consultant/ Receptionist
									</option>
									</select></font></td>
								</tr>
							</table>
							<table id="table15" border="0" cellpadding="0" cellspacing="0">
								<tr>
									<td class="style55" height="15"><strong>First 
									Name&nbsp; </strong></td>
									<td nowrap rowspan="2" width="5"></td>
									<td class="style55"><strong>Last Name
									</strong></td>
									<td nowrap rowspan="2" width="5"></td>
								</tr>
								<tr>
									<td><font face="Tahoma">
									<input class="style56" maxlength="50" name="FirstName" size="14" style="font-weight: 700"></font></td>
									<td><font face="Tahoma">
									<input class="style56" maxlength="50" name="LastName" size="20" style="font-weight: 700"></font></td>
								</tr>
							</table>
							<table id="table16" border="0" cellpadding="0" cellspacing="0">
								<tr>
									<td class="style55" height="15"><strong>Address
									</strong></td>
								</tr>
								<tr>
									<td><font face="Tahoma">
									<input class="style56" maxlength="50" name="Address" size="30" style="font-weight: 700"></font></td>
								</tr>
								<tr>
									<td class="style55" height="2" nowrap>
									<strong>Address 2</strong></td>
								</tr>
								<tr>
									<td><font face="Tahoma">
									<input class="style56" maxlength="50" name="Address2" size="30" style="font-weight: 700"></font></td>
								</tr>
							</table>
							<table id="table17" border="0" cellpadding="0" cellspacing="0">
								<tr>
									<td class="style55" height="15"><strong>Town/City
									</strong></td>
									<td nowrap rowspan="2" width="5"></td>
									<td align="CENTER"><font size="2"><strong>State
									</strong></font></td>
									<td nowrap rowspan="2" width="5"></td>
									<td><font size="2"><strong>Zip</strong><span class="style29"><strong>
									</strong></span></font></td>
								</tr>
								<tr>
									<td><font face="Tahoma">
									<input class="style56" maxlength="50" name="City" size="20" style="font-weight: 700"></font></td>
									<td align="CENTER"><font face="Tahoma">
									<input class="style56" maxlength="2" name="State" size="2" style="font-weight: 700"></font></td>
									<td><font face="Tahoma">
									<input class="style56" maxlength="5" name="Zip" size="5" style="font-weight: 700"></font></td>
								</tr>
							</table>
							<table id="table19" border="0" cellpadding="0" cellspacing="0">
								<tr>
									<td class="style28" colspan="4" height="15">
									<font size="2"><strong>Daytime Phone</strong></font><font size="1">
									</font></td>
								</tr>
								<tr>
									<td><font face="Tahoma">
									<input class="style56" maxlength="3" name="DayArea" size="3" style="font-weight: 700"></font></td>
									<td><font face="Tahoma">
									<input class="style56" maxlength="8" name="DayPhone" size="8" style="font-weight: 700"></font></td>
									<td><b><font size="1">Ext.</font></b></td>
									<td><font face="Tahoma">
									<input class="style56" maxlength="5" name="DayExt" size="5" style="font-weight: 700"></font></td>
								</tr>
								<tr>
									<td class="style55" colspan="2" height="17">
									<strong>Evening Phone </strong></td>
								</tr>
								<tr>
									<td><font face="Tahoma">
									<input class="style56" maxlength="3" name="NightArea" size="3" style="font-weight: 700"></font></td>
									<td><font face="Tahoma">
									<input class="style56" maxlength="8" name="NightPhone" size="8" style="font-weight: 700"></font></td>
								</tr>
								<tr>
									<td colspan="2"><b><font size="2">Mobile/Other 
									Phone<span class="style29"> </span></font>
									</b></td>
								</tr>
								<tr>
									<td><font face="Tahoma">
									<input class="style56" maxlength="3" name="MobileArea" size="3" style="font-weight: 700"></font></td>
									<td><font face="Tahoma">
									<input class="style56" maxlength="8" name="MobilePhone" size="8" style="font-weight: 700"></font></td>
								</tr>
							</table>
							<table id="table20" border="0" cellpadding="0" cellspacing="0">
								<tr>
									<td class="style28" height="15">
									<font size="2"><strong>Email Address</strong><span lang="en-us"><strong>
									</strong></span></font><span lang="en-us">
									<strong><span class="style59">*</span></strong></span></td>
								</tr>
							</table>
							<table id="table21" border="0" cellpadding="0" cellspacing="0">
								<tr>
									<td><font face="Tahoma">
									<input class="style56" maxlength="150" name="EmailAddress" size="20" style="font-weight: 700"></font></td>
								</tr>
								<tr>
									<td>&nbsp;</td>
								</tr>
							</table>
							</td>
						</tr>
					</table>
					</td>
				</tr>
				<tr>
					<td class="style44" valign="top">
					<table align="center" cellpadding="10" cellspacing="0" style="width: 80%">
						<tr>
							<td style="font-size: 10pt"><font face="Tahoma">
							<table id="table11" border="0" cellpadding="0" cellspacing="0" width="645">
								<tr>
									<td width="45"><b>&nbsp;</b></td>
									<td nowrap style="font-size: 10pt" valign="TOP" width="287">
									<table id="table12" border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td colspan="3" height="15"><b>
											<font size="1"><strong>If you are under 
											18, and it is required, can you furnish 
											a work permit?</strong></font></b><strong></strong></td>
										</tr>
										<tr>
											<td width="63"><font face="Tahoma">
											<input checked name="WorkPermit" style="font-weight: 700" type="radio" value="Yes"></font><b>
											<font size="1">yes</font> </b></td>
											<td width="5">&nbsp;</td>
											<td width="194">
											<font face="Tahoma" size="1">
											<input name="WorkPermit" style="font-weight: 700" type="radio" value="No"></font><b><font size="1"> 
											no</font></b></td>
										</tr>
										<tr>
											<td colspan="3"><b><font size="1">If 
											no, please explain</font></b></td>
										</tr>
										<tr>
											<td colspan="3"><font face="Tahoma">
											<strong>
											<textarea cols="30" name="WorkPermitWhy" rows="3" style="font-weight: 700"></textarea></strong></font></td>
										</tr>
									</table>
									<br class="style28">
									<table id="table13" border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td colspan="3" height="15"><b>
											<font size="1">Have you ever been employed 
											here before?</font></b></td>
										</tr>
										<tr>
											<td width="63"><font face="Tahoma">
											<input checked name="PreviouslyEmployed" style="font-weight: 700" type="radio" value="Yes"></font><b>
											<font size="1">yes</font> </b></td>
											<td width="5">&nbsp;</td>
											<td width="194"><font face="Tahoma">
											<input name="PreviouslyEmployed" style="font-weight: 700" type="radio" value="No"></font><b>
											<font size="1">no</font></b></td>
										</tr>
										<tr>
											<td colspan="3"><b><font size="1">If 
											yes, give dates and positions</font></b></td>
										</tr>
										<tr>
											<td colspan="3"><font face="Tahoma">
											<textarea cols="30" name="PreviouslyEmployedWhen" rows="3" style="font-weight: 700"></textarea></font></td>
										</tr>
									</table>
									<br class="style28">
									<table id="table14" border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td colspan="3" height="15"><b>
											<font size="1">Are you legally eligible 
											for employment in this country?</font></b></td>
										</tr>
										<tr>
											<td width="63"><font face="Tahoma">
											<input checked name="LegallyEligible" style="font-weight: 700" type="radio" value="Yes"></font><b>
											<font size="1">yes</font> </b></td>
											<td width="5">&nbsp;</td>
											<td width="194"><font face="Tahoma">
											<input name="LegallyEligible" style="font-weight: 700" type="radio" value="No"></font><b>
											<font size="1">no</font></b></td>
										</tr>
										<tr>
											<td colspan="3" width="262">&nbsp;</td>
										</tr>
										<tr>
											<td colspan="3" width="262">
											<span lang="en-us"><font size="1">
											<b>License #</b></font></span></td>
										</tr>
										<tr>
											<td colspan="3" width="262">
											<input name="LicenseNumber" size="32" style="font-weight: 700"></td>
										</tr>
									</table>
									<br class="style28">
									<table id="table15" border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td height="15"><b><font size="1">Date 
											available for work</font></b></td>
										</tr>
										<tr>
											<td>
											<table id="table16" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<select name="AvailableMonth" style="font-weight: 700">
													<option selected="" value="0">
													Month</option>
													<option value="January">January
													</option>
													<option value="February">February
													</option>
													<option value="March">March
													</option>
													<option value="April">April
													</option>
													<option value="May">May
													</option>
													<option value="June">June
													</option>
													<option value="July">July
													</option>
													<option value="August">August
													</option>
													<option value="September">September
													</option>
													<option value="October">October
													</option>
													<option value="November">November
													</option>
													<option value="December">December
													</option>
													</select></font></td>
													<td></td>
													<td><font face="Tahoma">
													<select name="AvailableDay" style="font-weight: 700">
													<option selected="" value="0">
													Day</option>
													<option value="1">1</option>
													<option value="2">2</option>
													<option value="3">3</option>
													<option value="4">4</option>
													<option value="5">5</option>
													<option value="6">6</option>
													<option value="7">7</option>
													<option value="8">8</option>
													<option value="9">9</option>
													<option value="10">10
													</option>
													<option value="11">11
													</option>
													<option value="12">12
													</option>
													<option value="13">13
													</option>
													<option value="14">14
													</option>
													<option value="15">15
													</option>
													<option value="16">16
													</option>
													<option value="17">17
													</option>
													<option value="18">18
													</option>
													<option value="19">19
													</option>
													<option value="20">20
													</option>
													<option value="21">21
													</option>
													<option value="22">22
													</option>
													<option value="23">23
													</option>
													<option value="24">24
													</option>
													<option value="25">25
													</option>
													<option value="26">26
													</option>
													<option value="27">27
													</option>
													<option value="28">28
													</option>
													<option value="29">29
													</option>
													<option value="30">30
													</option>
													<option value="31">31
													</option>
													</select></font></td>
													<td></td>
													<td><font face="Tahoma">
													<select name="AvailableYear" style="font-weight: 700">
													<option selected="" value="0">
													Year</option>
													<option value="2003">2003
													</option>
													<option value="2004">2004
													</option>
													<option value="2005">2005
													</option>
													<option value="2006">2006
													</option>
													<option value="2007">2007
													</option>
													<option value="2008">2008
													</option>
													<option value="2009">2009
													</option>
													</select></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr>
											<td><b><font size="1"><br>What is your 
											desired salary range?</font></b></td>
										</tr>
										<tr>
											<td></strong><font face="Tahoma">
											<strong>
											<input maxlength="50" name="DesiredSalary" size="30" style="font-weight: 700"></strong></font></td>
										</tr>
									</table>
									</td>
									<td nowrap valign="TOP" width="288">
									<table id="table17" border="0" cellpadding="0" cellspacing="0" width="291">
										<tr>
											<td colspan="5" height="15"><b>
											<font size="1">Type of employment desired</font></b></td>
										</tr>
										<tr>
											<td width="85"><font face="Tahoma">
											<input name="Full-Time" style="font-weight: 700" type="checkbox"></font><b>
											<font size="1">Full-Time</font> </b>
											</td>
											<td width="5">&nbsp;</td>
											<td width="85"><font face="Tahoma">
											<input name="Part-Time" style="font-weight: 700" type="checkbox"></font><b>
											<font size="1">Part-Time</font></b></td>
											<td width="5">&nbsp;</td>
											<td width="94"><font face="Tahoma">
											<input name="Temporary" style="font-weight: 700" type="checkbox"></font><b>
											<font size="1">Temporary</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="Seasonal" style="font-weight: 700" type="checkbox"></font><b>
											<font size="1">Seasonal</font> </b>
											</td>
											<td>&nbsp;</td>
											<td colspan="3"><font face="Tahoma">
											<input name="Educational" style="font-weight: 700" type="checkbox"></font><b>
											<font size="1">Educational Co-Op
											</font></b></td>
										</tr>
									</table>
									<br class="style28">
									<table id="table18" border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td colspan="3" height="15"><b>
											<font size="1">Are you able to meet 
											the requirements of the position?</font></b></td>
										</tr>
										<tr>
											<td width="63"><font face="Tahoma">
											<input checked name="MeetRequirements" style="font-weight: 700" type="radio" value="Yes"></font><b>
											<font size="1">yes</font> </b></td>
											<td width="5">&nbsp;</td>
											<td width="194"><font face="Tahoma">
											<input name="MeetRequirements" style="font-weight: 700" type="radio" value="No"></font><b>
											<font size="1">No</font></b></td>
										</tr>
									</table>
									<br class="style28">
									<table id="table19" border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td colspan="3" height="15"><b>
											<font size="1">Have you ever pled &quot;guilty&quot; 
											or &quot;no contest&quot; to, or been convicted 
											of a crime?</font></b></td>
										</tr>
										<tr>
											<td height="21" width="63">
											<font face="Tahoma">
											<input checked name="Convicted" style="font-weight: 700" type="radio" value="Yes"></font><b>
											<font size="1">yes</font> </b></td>
											<td height="21" width="5">&nbsp;</td>
											<td height="21" width="194">
											<font face="Tahoma">
											<input name="Convicted" style="font-weight: 700" type="radio" value="No"></font><b>
											<font size="1">No</font></b></td>
										</tr>
										<tr>
											<td colspan="3"><font size="1">If yes 
											please provide date(s) and details<br>
											<font class="style46">ANSWERING &quot;YES&quot; 
											TO THESE QUESTIONS DOES NOT CONSTITUTE 
											AN AUTOMATIC BAR TO EMPLOYMENT. FACTORS 
											SUCH AS DATE OF THE OFFENSE, SERIOUSNESS 
											AND NATURE OF THE VIOLATION, REHABILITATION 
											AND POSITION APPLIED FOR WILL BE TAKEN 
											INTO CONSIDERATION </font></font>
											</td>
										</tr>
										<tr>
											<td colspan="3"><font face="Tahoma">
											<textarea cols="30" name="ConvictedWhen" rows="3" style="font-weight: 700"></textarea></font></td>
										</tr>
									</table>
									<br class="style28">
									<table id="table20" border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td><b><font size="1">Drivers license 
											number if driving is an essential job 
											function</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input maxlength="50" name="DriversLicenseNumber" size="30" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<p class="style29">&nbsp;</p>
									</td>
								</tr>
							</table>
							</font></td>
						</tr>
					</table>
					</td>
				</tr>
				<tr>
					<td class="style44" valign="top">
					<table align="center" cellpadding="10" cellspacing="0" style="width: 80%">
						<tr>
							<td valign="top"><font face="Tahoma">
							<table id="table11" border="0" cellpadding="0" cellspacing="0" width="645">
								<tr>
									<td width="45"><b>&nbsp;</b></td>
									<td align="left" height="1486" nowrap>
									<table id="table12" border="0" cellpadding="0" cellspacing="0" width="583">
										<tr align="left" valign="top">
											<td height="7" width="258"><b>
											<font size="2">1:</font></b></td>
											<td width="325"><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
											</b></td>
										</tr>
										<tr align="left" valign="top">
											<td height="8"><b><font size="1">From</font></b></td>
											<td><b><font size="1">Employer</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table13" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="2" name="FromMonth1" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input maxlength="2" name="FromDay1" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input maxlength="4" name="FromYear1" size="4" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td><font face="Tahoma">
											<input maxlength="150" name="Employer1" size="30" style="font-weight: 700" /></font></td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1">To:</font></b></td>
											<td><b><font size="1">Telephone</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table14" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="2" name="ToMonth1" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input maxlength="2" name="ToDay1" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input maxlength="4" name="ToYear1" size="4" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td>
											<table id="table15" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="3" name="EmployerArea1" size="3" style="font-weight: 700" /></font></td>
													<td><font face="Tahoma">
													<input maxlength="8" name="EmployerPhone1" size="8" style="font-weight: 700" /></font></td>
													<td><b><font size="1">Ext.</font></b></td>
													<td><font face="Tahoma">
													<input maxlength="5" name="EmployerExt1" size="5" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1"><br>Starting Job 
											Title/Final Job title</font></b></td>
											<td valign="bottom"><b>
											<font size="1">Address</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table16" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="StartingJobTitle1" size="30" style="font-weight: 700" /></font></td>
												</tr>
												<tr>
													<td height="2" nowrap></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="FinalJobTitle1" size="30" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td>
											<table id="table17" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="EmployerAddress1" size="30" style="font-weight: 700" /></font></td>
												</tr>
												<tr>
													<td height="2" nowrap></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="EmployerAddress21" size="30" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td valign="bottom"><b>
											<font size="1">Immediate supervisor 
											and title</font></b></td>
											<td valign="bottom"><b>
											<font size="1"><br>Summarize nature 
											of work performed and job responsibilities</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td><font face="Tahoma">
											<input name="Supervisor1" size="30" style="font-weight: 700" /></font></td>
											<td rowspan="2"><font face="Tahoma">
											<textarea cols="30" name="WorkSummary1" rows="3" style="font-weight: 700"></textarea></font></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table18" border="0" cellpadding="0" cellspacing="0" width="211">
												<tr>
													<td colspan="5"><b>
													<font size="1">May we contact 
													for reference?</font> </b>
													</td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input checked name="MayWeContact1" style="font-weight: 700" type="radio" value="Yes" /></font><b>
													<font size="1">Yes</font>
													</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="MayWeContact1" style="font-weight: 700" type="radio" value="No" /></font><b>
													<font size="1">No</font></b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="MayWeContact1" style="font-weight: 700" type="radio" value="Later" /></font><b>
													<font size="1">Later</font></b></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1">Reason for leaving</font></b></td>
											<td><b><font size="1">Hourly rate/Salary
											</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td><font face="Tahoma">
											<input name="ReasonForLeaving1" size="30" style="font-weight: 700" /></font></td>
											<td>
											<table id="table19" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td style="height: 19px" width="70">
													<b><font size="1">&nbsp;&nbsp; 
													Start</font></b></td>
													<td style="height: 19px"><b>
													<font size="1">Per</font></b></td>
													<td style="height: 19px"><b>
													<font size="1">&nbsp;&nbsp; 
													Final</font></b></td>
													<td style="height: 19px"><b>
													<font size="1">Per</font></b></td>
												</tr>
												<tr>
													<td><font size="1">$ </font>
													<b>
													<font face="Tahoma" size="1">
													<input name="StartingAmount1" size="5" /></font></b></td>
													<td style="width: 38px"><b>
													<font face="Tahoma" size="1">
													<input name="StartingPer1" size="5" /></font></b></td>
													<td><font size="1">$ </font>
													<b>
													<font face="Tahoma" size="1">
													<input name="FinalAmount1" size="5" /></font></b></td>
													<td style="width: 38px"><b>
													<font face="Tahoma" size="1">
													<input name="FinalPer1" size="5" /></font></b></td>
												</tr>
											</table>
											</td>
										</tr>
									</table>
									<br class="style28" />
									<table id="table20" border="0" cellpadding="0" cellspacing="0" width="583">
										<tr align="left" valign="top">
											<td height="7" width="258"><b>
											<font size="2">2:</font></b></td>
											<td width="325"><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
											</b></td>
										</tr>
										<tr align="left" valign="top">
											<td height="8"><b><font size="1">From</font></b></td>
											<td><b><font size="1">Employer</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table21" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input name="FromMonth2" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="FromDay2" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="FromYear2" size="4" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td><font face="Tahoma">
											<input name="Employer2" size="30" style="font-weight: 700" /></font></td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1">To:</font></b></td>
											<td><b><font size="1">Telephone</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table22" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input name="ToMonth2" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="ToDay2" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="ToYear2" size="4" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td>
											<table id="table23" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="3" name="EmployerArea2" size="3" style="font-weight: 700" /></font></td>
													<td><font face="Tahoma">
													<input maxlength="8" name="EmployerPhone2" size="8" style="font-weight: 700" /></font></td>
													<td><b><font size="1">Ext.</font></b></td>
													<td><font face="Tahoma">
													<input maxlength="5" name="EmployerExt2" size="5" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1"><br>Starting Job 
											Title/Final Job title</font></b></td>
											<td valign="bottom"><b>
											<font size="1">Address</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table24" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="StartingJobTitle2" size="30" style="font-weight: 700" /></font></td>
												</tr>
												<tr>
													<td height="2" nowrap></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="FinalJobTitle2" size="30" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td>
											<table id="table25" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="EmployerAddress2" size="30" style="font-weight: 700" /></font></td>
												</tr>
												<tr>
													<td height="2" nowrap></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="EmployerAddress22" size="30" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td valign="bottom"><b>
											<font size="1">Immediate supervisor 
											and title</font></b></td>
											<td><b><font size="1"><br>Summarize 
											nature of work performed and job responsibilities</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td><font face="Tahoma">
											<input name="Supervisor2" size="30" style="font-weight: 700" /></font></td>
											<td rowspan="2"><font face="Tahoma">
											<textarea cols="30" name="WorkSummary2" rows="3" style="font-weight: 700"></textarea></font></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table26" border="0" cellpadding="0" cellspacing="0" width="211">
												<tr>
													<td colspan="5"><b>
													<font size="1">May we contact 
													for reference?</font> </b>
													</td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input checked name="MayWeContact2" style="font-weight: 700" type="radio" value="Yes" /></font><b>
													<font size="1">Yes</font>
													</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="MayWeContact2" style="font-weight: 700" type="radio" value="No" /></font><b>
													<font size="1">No</font></b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="MayWeContact2" style="font-weight: 700" type="radio" value="Later" /></font><b>
													<font size="1">Later</font></b></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1"><br>Reason for 
											leaving</font></b></td>
											<td valign="bottom"><b>
											<font size="1">Hourly rate/Salary
											</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td><font face="Tahoma">
											<input name="ReasonForLeaving2" size="30" style="font-weight: 700" /></font></td>
											<td>
											<table id="table27" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Start</font></b></td>
													<td style="width: 38px"><b>
													<font size="1">Per</font></b></td>
													<td style="width: 47px"><b>
													<font size="1">&nbsp;&nbsp; 
													Final</font></b></td>
													<td style="width: 38px"><b>
													<font size="1">Per</font></b></td>
												</tr>
												<tr>
													<td><font size="1">$ </font>
													<b>
													<font face="Tahoma" size="1">
													<input name="StartingAmount2" size="5" /></font></b></td>
													<td style="width: 38px"><b>
													<font face="Tahoma" size="1">
													<input name="StartingPer2" size="5" /></font></b></td>
													<td><font size="1">$ </font>
													<b>
													<font face="Tahoma" size="1">
													<input name="FinalAmount2" size="5" /></font></b></td>
													<td style="width: 38px"><b>
													<font face="Tahoma" size="1">
													<input name="FinalPer2" size="5" /></font></b></td>
												</tr>
											</table>
											</td>
										</tr>
									</table>
									<br class="style28" />
									<table id="table28" border="0" cellpadding="0" cellspacing="0" width="583">
										<tr align="left" valign="top">
											<td height="7" width="258"><b>
											<font size="2">3:</font></b></td>
											<td width="325"><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
											</b></td>
										</tr>
										<tr align="left" valign="top">
											<td height="8"><b><font size="1">From</font></b></td>
											<td><b><font size="1">Employer</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table29" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input name="FromMonth3" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="FromDay3" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="FromYear3" size="4" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td><font face="Tahoma">
											<input name="Employer3" size="30" style="font-weight: 700" /></font></td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1">To:</font></b></td>
											<td><b><font size="1">Telephone</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table30" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input name="ToMonth3" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="ToDay3" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="ToYear3" size="4" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td>
											<table id="table31" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="3" name="EmployerArea3" size="3" style="font-weight: 700" /></font></td>
													<td><font face="Tahoma">
													<input maxlength="8" name="EmployerPhone3" size="8" style="font-weight: 700" /></font></td>
													<td><b><font size="1">Ext.</font></b></td>
													<td><font face="Tahoma">
													<input maxlength="5" name="EmployerExt3" size="5" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1"><br>Starting Job 
											Title/Final Job title</font></b></td>
											<td valign="bottom"><b>
											<font size="1">Address</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table32" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="StartingJobTitle3" size="30" style="font-weight: 700" /></font></td>
												</tr>
												<tr>
													<td height="2" nowrap></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="FinalJobTitle3" size="30" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td>
											<table id="table33" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="EmployerAddress3" size="30" style="font-weight: 700" /></font></td>
												</tr>
												<tr>
													<td height="2" nowrap></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="EmployerAddress23" size="30" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td valign="bottom"><b>
											<font size="1">Immediate supervisor 
											and title</font></b></td>
											<td><b><font size="1"><br>Summarize 
											nature of work performed and job responsibilities</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td><font face="Tahoma">
											<input name="Supervisor3" size="30" style="font-weight: 700" /></font></td>
											<td rowspan="2"><font face="Tahoma">
											<textarea cols="30" name="WorkSummary3" rows="3" style="font-weight: 700"></textarea></font></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table34" border="0" cellpadding="0" cellspacing="0" width="211">
												<tr>
													<td colspan="5"><b>
													<font size="1">May we contact 
													for reference?</font> </b>
													</td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input checked name="MayWeContact3" style="font-weight: 700" type="radio" value="Yes" /></font><b>
													<font size="1">Yes</font>
													</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="MayWeContact3" style="font-weight: 700" type="radio" value="No" /></font><b>
													<font size="1">No</font></b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="MayWeContact3" style="font-weight: 700" type="radio" value="Later" /></font><b>
													<font size="1">Later</font></b></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1"><br>Reason for 
											leaving</font></b></td>
											<td valign="bottom"><b>
											<font size="1">Hourly rate/Salary
											</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td><font face="Tahoma">
											<input name="ReasonForLeaving3" size="30" style="font-weight: 700" /></font></td>
											<td>
											<table id="table35" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td width="70"><b>
													<font size="1">&nbsp;&nbsp; 
													Start</font></b></td>
													<td><b><font size="1">Per</font></b></td>
													<td><b><font size="1">&nbsp;&nbsp; 
													Final</font></b></td>
													<td><b><font size="1">Per</font></b></td>
												</tr>
												<tr>
													<td><font size="1">$ </font>
													<b>
													<font face="Tahoma" size="1">
													<input name="StartingAmount3" size="5" /></font></b></td>
													<td><b>
													<font face="Tahoma" size="1">
													<input name="StartingPer3" size="5" /></font></b></td>
													<td><font size="1">$</font><b><font face="Tahoma" size="1"><input name="FinalAmount3" size="5" /></font></b></td>
													<td><b>
													<font face="Tahoma" size="1">
													<input name="FinalPer3" size="5" /></font></b></td>
												</tr>
											</table>
											</td>
										</tr>
									</table>
									<br class="style28" />
									<table id="table36" border="0" cellpadding="0" cellspacing="0" width="583">
										<tr align="left" valign="top">
											<td height="7" width="258"><b>
											<font size="2">4:</font></b></td>
											<td width="325"><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
											</b></td>
										</tr>
										<tr align="left" valign="top">
											<td height="8"><b><font size="1">From</font></b></td>
											<td><b><font size="1">Employer</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table37" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input name="FromMonth4" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="FromDay4" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="FromYear4" size="4" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td><font face="Tahoma">
											<input name="Employer4" size="30" style="font-weight: 700" /></font></td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1">To:</font></b></td>
											<td><b><font size="1">Telephone</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table38" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><b><font size="1">Month:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Day:</font>
													</b></td>
													<td></td>
													<td><b><font size="1">Year:</font>
													</b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input name="ToMonth4" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="ToDay4" size="2" style="font-weight: 700" /></font><b> 
													/</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="ToYear4" size="4" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td>
											<table id="table39" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="3" name="EmployerArea4" size="3" style="font-weight: 700" /></font></td>
													<td><font face="Tahoma">
													<input maxlength="8" name="EmployerPhone4" size="8" style="font-weight: 700" /></font></td>
													<td><b><font size="1">Ext.</font></b></td>
													<td><font face="Tahoma">
													<input maxlength="5" name="EmployerExt4" size="5" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1"><br>Starting Job 
											Title/Final Job title</font></b></td>
											<td valign="bottom"><b>
											<font size="1">Address</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table40" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="StartingJobTitle4" size="30" style="font-weight: 700" /></font></td>
												</tr>
												<tr>
													<td height="2" nowrap></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="FinalJobTitle4" size="30" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
											<td>
											<table id="table41" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="EmployerAddress4" size="30" style="font-weight: 700" /></font></td>
												</tr>
												<tr>
													<td height="2" nowrap></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input maxlength="30" name="EmployerAddress24" size="30" style="font-weight: 700" /></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td><b><font size="1"><br>Immediate 
											supervisor and title</font></b></td>
											<td valign="bottom"><b>
											<font size="1">Summarize nature of work 
											performed and job responsibilities</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td><font face="Tahoma">
											<input name="Supervisor4" size="30" style="font-weight: 700" /></font></td>
											<td rowspan="2"><font face="Tahoma">
											<textarea cols="30" name="WorkSummary4" rows="3" style="font-weight: 700"></textarea></font></td>
										</tr>
										<tr align="left" valign="top">
											<td>
											<table id="table42" border="0" cellpadding="0" cellspacing="0" width="211">
												<tr>
													<td colspan="5"><b>
													<font size="1">May we contact 
													for reference?</font> </b>
													</td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input checked name="MayWeContact4" style="font-weight: 700" type="radio" value="Yes" /></font><b>
													<font size="1">Yes</font>
													</b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="MayWeContact4" style="font-weight: 700" type="radio" value="No" /></font><b>
													<font size="1">No</font></b></td>
													<td></td>
													<td><font face="Tahoma">
													<input name="MayWeContact4" style="font-weight: 700" type="radio" value="Later" /></font><b>
													<font size="1">Later</font></b></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr align="left" valign="top">
											<td style="height: 12px"><b>
											<font size="1"><br>Reason for leaving</font></b></td>
											<td style="height: 12" valign="bottom">
											<b><font size="1">Hourly rate/Salary
											</font></b></td>
										</tr>
										<tr align="left" valign="top">
											<td><font face="Tahoma">
											<input name="ReasonForLeaving4" size="30" style="font-weight: 700" /></font></td>
											<td>
											<table id="table43" border="0" cellpadding="0" cellspacing="0">
												<tr>
													<td style="width: 47px"><b>
													<font size="1">&nbsp;&nbsp; 
													Start</font></b></td>
													<td style="width: 38px"><b>
													<font size="1">Per</font></b></td>
													<td style="width: 47px"><b>
													<font size="1">&nbsp;&nbsp; 
													Final</font></b></td>
													<td style="width: 38px"><b>
													<font size="1">Per</font></b></td>
												</tr>
												<tr>
													<td><font size="1">$ </font>
													<b>
													<font face="Tahoma" size="1">
													<input name="StartingAmount4" size="5" /></font></b></td>
													<td><b>
													<font face="Tahoma" size="1">
													<input name="StartingPer4" size="5" /></font></b></td>
													<td><font size="1">$ </font>
													<b>
													<font face="Tahoma" size="1">
													<input name="FinalAmount4" size="5" /></font></b></td>
													<td><b>
													<font face="Tahoma" size="1">
													<input name="FinalPer4" size="5" /></font></b></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr class="style1" valign="middle">
											<td class="style29" style="height: 20px" valign="bottom">&nbsp;</td>
										</tr>
									</table>
									</td>
								</tr>
							</table>
							</font></td>
						</tr>
					</table>
					</td>
				</tr>
				<tr>
					<td class="style44" valign="top">
					<table border="0" cellpadding="0" cellspacing="0" width="100%">
						<tr>
							<td bgcolor="">
							<table align="center" border="0" cellpadding="0" cellspacing="0" width="645">
								<tr>
									<td width="45"><b>&nbsp;</b></td>
									<td width="287"><font size="2"><b>Skills and 
									Qualifications</b></font></td>
									<td width="288"><font size="2"><b>Educational 
									Background </b></font></td>
								</tr>
								<tr>
									<td height="5" width="45"></td>
									<td colspan="2" width="545">&nbsp;</td>
								</tr>
							</table>
							<table align="center" border="0" cellpadding="0" cellspacing="0" width="645">
								<tr>
									<td rowspan="4" width="46"><b>&nbsp;</b></td>
									<td height="100" nowrap valign="TOP" width="303">
									<table border="0" cellpadding="0" cellspacing="0" style="width: 274px; height: 194px">
										<tr>
											<td height="15" width="262"><b>
											<font size="1">Summarize any training, 
											skills, licenses and/or certificates 
											that may qualify you as being able to 
											perform job related functions in the 
											position for which you are applying.</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<textarea name="SkillSummary" style="font-weight: 700; width: 270px; height: 145px;"></textarea></font></td>
										</tr>
									</table>
									</td>
									<td nowrap rowspan="4" valign="TOP" width="296">
									<table border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td width="262"><b><font size="1">High 
											School</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="HighSchool" size="30" style="font-weight: 700"></font></td>
										</tr>
										<tr>
											<td><b><font size="1">Number of years 
											completed</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="HSYears" size="30" style="font-weight: 700"></font></td>
										</tr>
										<tr>
											<td><b><font size="1">Did you graduate?</font></b></td>
										</tr>
										<tr>
											<td>
											<table border="0" cellpadding="0" cellspacing="0" width="262">
												<tr>
													<td width="63">
													<font face="Tahoma">
													<input checked="true" name="HSGraduate" style="font-weight: 700" type="radio" value="Yes"></font><b>
													<font size="1">yes</font>
													</b></td>
													<td width="5">&nbsp;</td>
													<td width="194">
													<font face="Tahoma">
													<input name="HSGraduate" style="font-weight: 700" type="radio" value="No"></font><b>
													<font size="1">No</font></b></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr>
											<td><b><font size="1">Course of study</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="HSStudy" size="30" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<b><br></b>
									<table border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td width="262"><b><font size="1">College</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="College" size="30" style="font-weight: 700"></font></td>
										</tr>
										<tr>
											<td><b><font size="1">Number of years 
											completed</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="ColYears" size="30" style="font-weight: 700"></font></td>
										</tr>
										<tr>
											<td><b><font size="1">Did you graduate?</font></b></td>
										</tr>
										<tr>
											<td>
											<table border="0" cellpadding="0" cellspacing="0" width="262">
												<tr>
													<td width="63">
													<font face="Tahoma">
													<input checked="true" name="ColGraduate" style="font-weight: 700" type="radio" value="Yes"></font><b>
													<font size="1">yes</font>
													</b></td>
													<td width="5">&nbsp;</td>
													<td width="194">
													<font face="Tahoma">
													<input name="ColGraduate" style="font-weight: 700" type="radio" value="No"></font><b>
													<font size="1">No</font></b></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr>
											<td>
											<table border="0" cellpadding="0" cellspacing="0" width="262">
												<tr>
													<td width="63"><b>
													<font size="1">Major </font>
													</b></td>
													<td width="5">&nbsp;</td>
													<td width="194"><b>
													<font size="1">Degree</font></b></td>
												</tr>
												<tr>
													<td><font face="Tahoma">
													<input name="ColMajor" size="13" style="font-weight: 700"></font></td>
													<td>&nbsp;</td>
													<td><font face="Tahoma">
													<input name="ColDegree" size="13" style="font-weight: 700"></font></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr>
											<td><b><font size="1">Course of study</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="ColStudy" size="30" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<b><br></b>
									<table border="0" cellpadding="0" cellspacing="0" width="262">
										<tr>
											<td width="262"><b><font size="1">Other</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="OthSchool" size="30" style="font-weight: 700"></font></td>
										</tr>
										<tr>
											<td><b><font size="1">Number of years 
											completed</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="OthYears" size="30" style="font-weight: 700"></font></td>
										</tr>
										<tr>
											<td><b><font size="1">Did you graduate?</font></b></td>
										</tr>
										<tr>
											<td>
											<table border="0" cellpadding="0" cellspacing="0" width="262">
												<tr>
													<td width="63">
													<font face="Tahoma">
													<input checked="true" name="OthGraduate" style="font-weight: 700" type="radio" value="Yes"></font><b>
													<font size="1">yes</font>
													</b></td>
													<td width="5">&nbsp;</td>
													<td width="194">
													<font face="Tahoma">
													<input name="OthGraduate" style="font-weight: 700" type="radio" value="No"></font><b>
													<font size="1">No</font></b></td>
												</tr>
											</table>
											</td>
										</tr>
										<tr>
											<td><b><font size="1">Course of study</font></b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input name="OthStudy" size="30" style="font-weight: 700"></font></td>
										</tr>
										<tr>
											<td>
											<p><b><br></b><span class="style55">
											<strong>How did you hear about MassageLuxe?</strong></span></p>
											<p><font face="Tahoma">
											<textarea cols="30" name="HowHear" rows="3" style="font-weight: 700"></textarea></font></p>
											</td>
										</tr>
									</table>
									</td>
								</tr>
								<tr>
									<td nowrap valign="TOP"><font size="2"><b>
									<br>References</b></font></td>
								</tr>
								<tr>
									<td height="5" nowrap valign="TOP"><b></b>
									</td>
								</tr>
								<tr>
									<td nowrap valign="TOP"><b><font size="2">1:</font></b><table border="0" cellpadding="0" cellspacing="0">
										<tr>
											<td height="15"><b><font size="1">First 
											Name </font></b></td>
											<td nowrap rowspan="2" width="5">
											</td>
											<td><b><font size="1">Last Name
											</font></b></td>
											<td nowrap rowspan="2" width="5">
											</td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input maxlength="14" name="ReferenceFirstName1" size="14" style="font-weight: 700"></font></td>
											<td><font face="Tahoma">
											<input maxlength="20" name="ReferenceLastName1" size="20" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<table border="0" cellpadding="0" cellspacing="0">
										<tr>
											<td colspan="4" height="15"><b>
											<font size="1">Daytime Phone </font>
											</b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input maxlength="3" name="ReferenceDayArea1" size="3" style="font-weight: 700"></font></td>
											<td><font face="Tahoma">
											<input maxlength="8" name="ReferenceDayPhone1" size="8" style="font-weight: 700"></font></td>
											<td><b><font size="1">Ext.</font></b></td>
											<td><font face="Tahoma">
											<input maxlength="5" name="ReferenceDayExt1" size="5" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<table border="0" cellpadding="0" cellspacing="0" width="172">
										<tr>
											<td height="15"><b><font size="1">Years 
											known</font> </b></td>
										</tr>
										<tr>
											<td height="15">
											<font face="Tahoma" size="1">
											<input maxlength="8" name="ReferenceYearsKnown1" size="8" style="font-weight: 700"></font><font size="1"><b>
											</b></font></td>
										</tr>
									</table>
									<b><br><font size="2">2:</font></b><table border="0" cellpadding="0" cellspacing="0">
										<tr>
											<td height="15"><b><font size="1">First 
											Name </font></b></td>
											<td nowrap rowspan="2" width="5">
											</td>
											<td><b><font size="1">Last Name
											</font></b></td>
											<td nowrap rowspan="2" width="5">
											</td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input maxlength="14" name="ReferenceFirstName2" size="14" style="font-weight: 700"></font></td>
											<td><font face="Tahoma">
											<input maxlength="20" name="ReferenceLastName2" size="20" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<table border="0" cellpadding="0" cellspacing="0">
										<tr>
											<td colspan="4" height="15"><b>
											<font size="1">Daytime Phone </font>
											</b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input maxlength="3" name="ReferenceDayArea2" size="3" style="font-weight: 700"></font></td>
											<td><font face="Tahoma">
											<input maxlength="8" name="ReferenceDayPhone2" size="8" style="font-weight: 700"></font></td>
											<td><b><font size="1">Ext.</font></b></td>
											<td><font face="Tahoma">
											<input maxlength="5" name="ReferenceDayExt2" size="5" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<table border="0" cellpadding="0" cellspacing="0" width="172">
										<tr>
											<td height="15"><b><font size="1">Years 
											known</font> </b></td>
										</tr>
										<tr>
											<td height="15">
											<font face="Tahoma" size="1">
											<input maxlength="8" name="ReferenceYearsKnown2" size="8" style="font-weight: 700"></font><font size="1"><b>
											</b></font></td>
										</tr>
									</table>
									<b><br><font size="2">3:</font></b><table border="0" cellpadding="0" cellspacing="0">
										<tr>
											<td height="15"><b><font size="1">First 
											Name </font></b></td>
											<td nowrap rowspan="2" width="5">
											</td>
											<td><b><font size="1">Last Name
											</font></b></td>
											<td nowrap rowspan="2" width="5">
											</td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input maxlength="14" name="ReferenceFirstName3" size="14" style="font-weight: 700"></font></td>
											<td><font face="Tahoma">
											<input maxlength="20" name="ReferenceLastName3" size="20" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<table border="0" cellpadding="0" cellspacing="0">
										<tr>
											<td colspan="4" height="15"><b>
											<font size="1">Daytime Phone </font>
											</b></td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input maxlength="3" name="ReferenceDayArea3" size="3" style="font-weight: 700"></font></td>
											<td><font face="Tahoma">
											<input maxlength="8" name="ReferenceDayPhone3" size="8" style="font-weight: 700"></font></td>
											<td><b><font size="1">Ext.</font></b></td>
											<td><font face="Tahoma">
											<input maxlength="5" name="ReferenceDayExt3" size="5" style="font-weight: 700"></font></td>
										</tr>
									</table>
									<table border="0" cellpadding="0" cellspacing="0" width="172">
										<tr>
											<td height="15"><b><font size="1">Years 
											known</font> </b></td>
										</tr>
										<tr>
											<td height="15">
											<font face="Tahoma" size="1">
											<input maxlength="8" name="ReferenceYearsKnown3" size="8" style="font-weight: 700"></font><font size="1"><b>
											</b></font></td>
										</tr>
									</table>
									</td>
								</tr>
							</table>
							<table align="center" border="0" cellpadding="0" cellspacing="0" width="645">
								<tr>
									<td width="45"><b>&nbsp;</b></td>
									<td width="287"><font size="2"><b><br>Applicant 
									Statement</b></font></td>
									<td width="288"><b><font size="2">&nbsp;</font>
									</b></td>
								</tr>
								<tr>
									<td height="5" width="45"></td>
									<td colspan="2" width="545"><b></b></td>
								</tr>
								<tr>
									<td height="5"></td>
									<td class="style60" colspan="2">
									<font size="1" style="text-align: left">I certify 
									that all information I have provided in order 
									to apply for and secure work with the employer 
									is true, complete and correct.<br>I understand 
									that any information provided by me that is 
									found to be false, incomplete or misrepresented 
									in any respect, will be sufficient cause to 
									(1) cancel further consideration of this application, 
									or (2) immediately discharge me from the employers 
									service whenever it is discovered.<br>I expressly 
									authorize, without reservation, the employer, 
									its representatives, employees or agents to 
									contact and obtain information from all references 
									(personal and professional), employers, public 
									agencies, licensing authorities and educational 
									institutions and to otherwise verify the accuracy 
									of all information provided by me in this application, 
									resume or job interview. I hereby waive any 
									and all rights and claims I may have regarding 
									the employer, its agents, employees or representatives, 
									for seeking, gathering and using such information 
									in the employment process and all other persons, 
									corporations or organizations for furnishing 
									such information about me.<br>I understand that 
									the employer does not unlawfully discriminate 
									in employment and no question on this application 
									is used for the purpose of limiting or excusing 
									any applicant from consideration for employment 
									on a basis prohibited by applicable local, state 
									or federal law.<br>I understand that this application 
									remains current for only 30 days. At the conclusion 
									of that time, if I have not heard from the employer 
									and still wish to be considered for employment, 
									it will be necessary to reapply and fill out 
									a new application.<br>If I am hired, I understand 
									that I am free to resign at any time, with or 
									without cause and without prior notice, and 
									the employer reserves the same right to terminate 
									my employment at any time, with or without cause 
									and without prior notice, except as may be required 
									by law. This application does not constitute 
									an agreement or contract for employment for 
									any specified period or definite duration. I 
									understand that no supervisor or representative 
									of the employer is authorized to make any assurances 
									to the contrary and that no implied, oral or 
									written agreements contrary to the foregoing 
									express language are valid unless they are in 
									written and signed by the employers president.<br>
									I also understand that if I am hired, I will 
									be required to provide proof of identity and 
									legal authority to work in the United States 
									and that federal immigration laws require me 
									to complete an I-9 Form in this regard.</font></td>
								</tr>
							</table>
							<table align="center" border="0" cellpadding="0" cellspacing="0" width="645">
								<tr>
									<td width="45"><b>&nbsp;</b></td>
									<td><font size="2"><b><br>DO NOT SUBMIT THIS 
									FORM UNTIL YOU HAVE READ THE ABOVE APPLICANT 
									STATEMENT.</b></font></td>
								</tr>
								<tr>
									<td height="5" width="45"></td>
									<td width="545"><b></b></td>
								</tr>
								<tr>
									<td height="5"></td>
									<td><font face="Tahoma" size="1">
									<input name="Agree" style="font-weight: 700" type="checkbox"></font><font size="1"><b> 
									I certify that I have read, fully understand 
									and accept all terms of the foregoing Applicant 
									Statement.<span lang="en-us"><strong><span class="style59">*</span></strong></span></b></font></td>
								</tr>
								<tr>
									<td height="5"><br></td>
									<td>
									<table border="0" cellpadding="0" cellspacing="0" width="580">
										<tr>
											<td height="15"><b><font size="1">Name
											</font></b></td>
											<td nowrap rowspan="2" width="5">
											</td>
											<td><b><font size="1">&nbsp; </font>
											</b></td>
											<td nowrap rowspan="2" width="5">
											</td>
										</tr>
										<tr>
											<td><font face="Tahoma">
											<input maxlength="40" name="Name" size="40" style="font-weight: 700"></font><span lang="en-us"><strong><span class="style59">*</span></strong></span><b><font size="2"><br>
											</font></b></td>
											<td valign="top">
											<font face="Tahoma">
											<input id="Cancel" name="Cancel" onclick="window.location='application1.asp?Navbutton=0601&amp;Main=06'" style="font-weight: 700" type="button" value="Cancel"></font><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
											</b><font face="Tahoma">
											<input id="Submit" name="Submit" style="font-weight: 700" type="submit" value="I Agree, Submit"></font></td>
										</tr>
									</table>
									</td>
								</tr>
							</table>
							</td>
						</tr>
					</table>
					</td>
				</tr>
				<tr>
					<td class="style44" style="height: 75px"><span lang="en-us">
					<a href="contactus.asp"><span class="style26">CONTACT US</span></a><span class="style46">&nbsp;
					</span><span class="style48">|</span><span class="style41">
					</span><span class="style26">&nbsp;<a href="default.htm">HOME</a>&nbsp;
					<span class="style48">|&nbsp; </span></span></span>
					<a href="services.htm"><span class="style26">SERVICES</span></a><span class="style26">&nbsp;
					</span><span class="style48">|</span><span class="style41">
					</span><span class="style26">&nbsp;</span><a href="memberships.htm"><span class="style26">MEMBERSHIPS</span></a><span class="style26">&nbsp;
					</span><span class="style48">|</span><span class="style41">
					</span><span class="style26">&nbsp;<a href="AboutUs.htm">ABOUT 
					US</a></span><br><span class="style26">
					<a href="LocationsMO.htm">LOCATIONS</a>&nbsp;
					<span class="style48">|</span></span><span class="style22">
					</span><span class="style26">&nbsp;</span><a href="careers.htm"><span class="style26">CAREERS</span></a><span class="style26">
					</span><span class="style41">&nbsp;</span><span class="style48">|</span><span class="style26">&nbsp;
					</span>
					<a href="https://pconsite4.pconsite.com/CMS_MassageLuxe/POS/giftcards/onlinegiftcardcustomersearch.aspx" target="_blank">
					<span class="style26">GIFT CARDS</span></a><span class="style26">&nbsp;
					</span><span class="style48">|</span><span class="style26">&nbsp;
					</span><a href="Franchise.htm"><span class="style26">FRANCHISE</span></a></td>
				</tr>
			</table>
			</td>
		</tr>
	</table>
</form>
<script type="text/javascript"> var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); </script>
<script type="text/javascript"> var pageTracker = _gat._getTracker("UA-6604746-3"); pageTracker._initData(); pageTracker._trackPageview(); </script>

</body>

</html>
 
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<%

	LocationsApplied = Request.Form("LocationsApplied")
	Positions = Request.Form("Positions")
	EmailAddress = Request.Form("EmailAddress")

	if Request.Form("Agree")="on" then
		Agree="X"
	else
		Agree=" "
	end if

	msg = "APPLICATION FOR EMPLOYMENT" & vbCrLf & vbCrLf
	msg = msg & "Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and / or interview process should notify a representative of the Human Resources Department." & vbCrLf & vbCrLf
	msg = msg & "Location(s) applied for: " & vbCrLf
	msg = msg & Request.Form("LocationsApplied") & Request.Form("StorePhone") & vbCrLf & vbCrLf
	msg = msg & "Position(s) applied for: " & vbCrLf
	msg = msg & Request.Form("Positions") & vbCrLf & vbCrLf
	msg = msg & "        First Name: " & Request.Form("FirstName") & vbCrLf
	msg = msg & "         Last Name: " & Request.Form("LastName") & vbCrLf
	msg = msg & "           Address: " & Request.Form("Address") & vbCrLf
	msg = msg & "                  : " & Request.Form("Address2") & vbCrLf
	msg = msg & "         Town/City: " & Request.Form("City") & vbCrLf
	msg = msg & "             State: " & Request.Form("State") & vbCrLf
	msg = msg & "          Zip Code: " & Request.Form("Zip") & vbCrLf
	msg = msg & "           Country: US " & vbCrLf
	msg = msg & "     Daytime Phone: (" & Request.Form("DayArea") & ") " & Request.Form("DayPhone") & " ext. " & Request.Form("DayExt") &  vbCrLf
	msg = msg & "     Evening Phone: (" & Request.Form("NightArea") & ") " & Request.Form("NightPhone") & vbCrLf
	msg = msg & "Mobile/Other Phone: (" & Request.Form("MobileArea") & ") " & Request.Form("MobilePhone") & vbCrLf
	msg = msg & "     Email Address: " & Request.Form("EmailAddress") & vbCrLf & vbCrLf
	msg = msg & "APPLICATION INFORMATION" & vbCrLf & vbCrLf
	msg = msg & "If you are under 18, and it is required, can you furnish a work permit? " & Request.Form("WorkPermit") & vbCrLf
	msg = msg & "If no, please explain: " & vbCrLf
	msg = msg & Request.Form("WorkPermitWhy") & vbCrLf & vbCrLf
	msg = msg & "Have you ever been employed here before? " & Request.Form("PreviouslyEmployed") & vbCrLf
	msg = msg & "If yes, give dates and positions: " & vbCrLf
	msg = msg & Request.Form("PreviouslyEmployedWhen") & vbCrLf & vbCrLf
	msg = msg & "Are you legally eligible for employment in this country? " & Request.Form("LegallyEligible") & vbCrLf & vbCrLf
	msg = msg & " Date Available For Work: " & Request.Form("Availablemonth") & " " & Request.Form("Availableday") & ", " & Request.Form("Availableyear") & vbCrLf
	msg = msg & "    Desired Salary Range: " & Request.Form("DesiredSalary") & vbCrLf
	msg = msg & "      Employment Desired: " & vbCrLf
	if Request.Form("Full-Time")="on" then msg = msg & "                        : Full-Time" & vbCrLf
	if Request.Form("Part-Time")="on" then msg = msg & "                        : Part-Time" & vbCrLf
	if Request.Form("Temporary")="on" then msg = msg & "                        : Temporary" & vbCrLf
	if Request.Form("Seasonal")="on" then msg = msg & "                        : Seasonal" & vbCrLf
	if Request.Form("Educational")="on" then msg = msg & "                        : Educational Co-Op" & vbCrLf
	msg = msg & "Are you able to meet the requirements of the position? " & Request.Form("MeetRequirements") & vbCrLf & vbCrLf
	msg = msg & "License Number: " & Request.Form("LicenseNumber") & vbCrLf & vbCrLf
	msg = msg & "Have you ever pled ''guilty'' or ''no contest'' to, or been convicted of a crime? " & Request.Form("Convicted") & vbCrLf
	msg = msg & "If yes please provide date(s) and details: " & vbCrLf
	msg = msg & "ANSWERING ''YES'' TO THESE QUESTIONS DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT. FACTORS SUCH AS DATE OF THE OFFENSE, SERIOUSNESS AND NATURE OF THE VIOLATION, REHABILITATION AND AND POSITION APPLIED FOR WILL BE TAKEN INTO CONSIDERATION" & vbCrLf
	msg = msg & Request.Form("ConvictedWhen") & vbCrLf & vbCrLf
	msg = msg & "Drivers license number if driving is an essential job function: " & Request.Form("DriversLicenseNumber") & vbCrLf & vbCrLf
	msg = msg & "EMPLOYMENT HISTORY" & vbCrLf & vbCrLf
	msg = msg & "Provide the following information of your past four (4) employers, assignments or volunteer activities, starting with the most recent." & vbCrLf & vbCrLf
	msg = msg & "(1)                   Employer: " & Request.Form("Employer1") & vbCrLf
	msg = msg & "                          From: " & Request.Form("Frommonth1") & "/" & Request.Form("Fromday1") & "/" & Request.Form("Fromyear1") & vbCrLf
	msg = msg & "                            To: " & Request.Form("Tomonth1") & "/" & Request.Form("Today1") & "/" & Request.Form("Toyear1") & vbCrLf
	msg = msg & "            Starting Job Title: " & Request.Form("StartingJobTitle1") & vbCrLf
	msg = msg & "               Final Job Title: " & Request.Form("FinalJobTitle1") & vbCrLf
	msg = msg & "Immediate supervisor and title: " & Request.Form("Supervisor1") & vbCrLf
	msg = msg & "  May we contact for reference? " & Request.Form("MayWeContact1") & vbCrLf
	msg = msg & "            Reason for Leaving: " & Request.Form("ReasonForLeaving1") & vbCrLf
	msg = msg & "                     Telephone: (" & Request.Form("EmployerArea1") & ") " & Request.Form("EmployerPhone1") & " ext. " & Request.Form("EmployerExt1") & vbCrLf
	msg = msg & "                       Address: " & Request.Form("EmployerAddress1") & vbCrLf
	msg = msg & "                              : " & Request.Form("EmployerAddress21") & vbCrLf
	msg = msg & "Sumarize nature of work performed and job responsibilities: " & vbCrLf
	msg = msg & Request.Form("WorkSummary1") & vbCrLf
	msg = msg & "   Starting Hourly Rate/Salary: $" & Request.Form("StartingAmount1") & " Per " & Request.Form("StartingPer1") & vbCrLf
	msg = msg & "      Final Hourly Rate/Salary: $" & Request.Form("FinalAmount1") & " Per " & Request.Form("FinalPer1") & vbCrLf & vbCrLf
	msg = msg & "(2)                   Employer: " & Request.Form("Employer2") & vbCrLf
	msg = msg & "                          From: " & Request.Form("Frommonth2") & "/" & Request.Form("Fromday2") & "/" & Request.Form("Fromyear2") & vbCrLf
	msg = msg & "                            To: " & Request.Form("Tomonth2") & "/" & Request.Form("Today2") & "/" & Request.Form("Toyear2") & vbCrLf
	msg = msg & "            Starting Job Title: " & Request.Form("StartingJobTitle2") & vbCrLf
	msg = msg & "               Final Job Title: " & Request.Form("FinalJobTitle2") & vbCrLf
	msg = msg & "Immediate supervisor and title: " & Request.Form("Supervisor2") & vbCrLf
	msg = msg & "  May we contact for reference? " & Request.Form("MayWeContact2") & vbCrLf
	msg = msg & "            Reason for Leaving: " & Request.Form("ReasonForLeaving2") & vbCrLf
	msg = msg & "                     Telephone: (" & Request.Form("EmployerArea2") & ") " & Request.Form("EmployerPhone2") & " ext. " & Request.Form("EmployerExt2") & vbCrLf
	msg = msg & "                       Address: " & Request.Form("EmployerAddress2") & vbCrLf
	msg = msg & "                              : " & Request.Form("EmployerAddress22") & vbCrLf
	msg = msg & "Sumarize nature of work performed and job responsibilities: " & vbCrLf
	msg = msg & Request.Form("WorkSummary2") & vbCrLf
	msg = msg & "   Starting Hourly Rate/Salary: $" & Request.Form("StartingAmount2") & " Per " & Request.Form("StartingPer2") & vbCrLf
	msg = msg & "      Final Hourly Rate/Salary: $" & Request.Form("FinalAmount2") & " Per " & Request.Form("FinalPer2") & vbCrLf & vbCrLf
	msg = msg & "(3)                   Employer: " & Request.Form("Employer3") & vbCrLf
	msg = msg & "                          From: " & Request.Form("Frommonth3") & "/" & Request.Form("Fromday3") & "/" & Request.Form("Fromyear3") & vbCrLf
	msg = msg & "                            To: " & Request.Form("Tomonth3") & "/" & Request.Form("Today3") & "/" & Request.Form("Toyear3") & vbCrLf
	msg = msg & "            Starting Job Title: " & Request.Form("StartingJobTitle3") & vbCrLf
	msg = msg & "               Final Job Title: " & Request.Form("FinalJobTitle3") & vbCrLf
	msg = msg & "Immediate supervisor and title: " & Request.Form("Supervisor3") & vbCrLf
	msg = msg & "  May we contact for reference? " & Request.Form("MayWeContact3") & vbCrLf
	msg = msg & "            Reason for Leaving: " & Request.Form("ReasonForLeaving3") & vbCrLf
	msg = msg & "                     Telephone: (" & Request.Form("EmployerArea3") & ") " & Request.Form("EmployerPhone3") & " ext. " & Request.Form("EmployerExt3") & vbCrLf
	msg = msg & "                       Address: " & Request.Form("EmployerAddress3") & vbCrLf
	msg = msg & "                              : " & Request.Form("EmployerAddress23") & vbCrLf
	msg = msg & "Sumarize nature of work performed and job responsibilities: " & vbCrLf
	msg = msg & Request.Form("WorkSummary3") & vbCrLf
	msg = msg & "   Starting Hourly Rate/Salary: $" & Request.Form("StartingAmount3") & " Per " & Request.Form("StartingPer3") & vbCrLf
	msg = msg & "      Final Hourly Rate/Salary: $" & Request.Form("FinalAmount3") & " Per " & Request.Form("FinalPer3") & vbCrLf & vbCrLf
	msg = msg & "(4)                   Employer: " & Request.Form("Employer4") & vbCrLf
	msg = msg & "                          From: " & Request.Form("Frommonth4") & "/" & Request.Form("Fromday4") & "/" & Request.Form("Fromyear4") & vbCrLf
	msg = msg & "                            To: " & Request.Form("Tomonth4") & "/" & Request.Form("Today4") & "/" & Request.Form("Toyear4") & vbCrLf
	msg = msg & "            Starting Job Title: " & Request.Form("StartingJobTitle4") & vbCrLf
	msg = msg & "               Final Job Title: " & Request.Form("FinalJobTitle4") & vbCrLf
	msg = msg & "Immediate supervisor and title: " & Request.Form("Supervisor4") & vbCrLf
	msg = msg & "  May we contact for reference? " & Request.Form("MayWeContact4") & vbCrLf
	msg = msg & "            Reason for Leaving: " & Request.Form("ReasonForLeaving4") & vbCrLf
	msg = msg & "                     Telephone: (" & Request.Form("EmployerArea4") & ") " & Request.Form("EmployerPhone4") & " ext. " & Request.Form("EmployerExt4") & vbCrLf
	msg = msg & "                       Address: " & Request.Form("EmployerAddress4") & vbCrLf
	msg = msg & "                              : " & Request.Form("EmployerAddress24") & vbCrLf
	msg = msg & "Sumarize nature of work performed and job responsibilities: " & vbCrLf
	msg = msg & Request.Form("WorkSummary4") & vbCrLf
	msg = msg & "   Starting Hourly Rate/Salary: $" & Request.Form("StartingAmount4") & " Per " & Request.Form("StartingPer4") & vbCrLf
	msg = msg & "      Final Hourly Rate/Salary: $" & Request.Form("FinalAmount4") & " Per " & Request.Form("FinalPer4") & vbCrLf & vbCrLf
	msg = msg & "SKILLS AND QUALIFICATIONS" & vbCrLf & vbCrLf
	msg = msg & "Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job related functions in the position for which you are applying." & vbCrLf
	msg = msg & Request.Form("SkillSummary") & vbCrLf & vbCrLf
	msg = msg & "REFERENCES" & vbCrLf & vbCrLf
	msg = msg & "(1)   First Name: " & Request.Form("ReferenceFirstName1") & vbCrLf
	msg = msg & "       Last Name: " & Request.Form("ReferenceLastName1") & vbCrLf
	msg = msg & "   Daytime Phone: (" & Request.Form("ReferenceDayArea1") & ") " & Request.Form("ReferenceDayPhone1") & " ext. " & Request.Form("ReferenceDayExt1") &  vbCrLf
	msg = msg & "     Years Known: " & Request.Form("ReferenceYearsKnown1") & vbCrLf & vbCrLf
	msg = msg & "(2)   First Name: " & Request.Form("ReferenceFirstName2") & vbCrLf
	msg = msg & "       Last Name: " & Request.Form("ReferenceLastName2") & vbCrLf
	msg = msg & "   Daytime Phone: (" & Request.Form("ReferenceDayArea2") & ") " & Request.Form("ReferenceDayPhone2") & " ext. " & Request.Form("ReferenceDayExt2") &  vbCrLf
	msg = msg & "     Years Known: " & Request.Form("ReferenceYearsKnown2") & vbCrLf & vbCrLf
	msg = msg & "(3)   First Name: " & Request.Form("ReferenceFirstName3") & vbCrLf
	msg = msg & "       Last Name: " & Request.Form("ReferenceLastName3") & vbCrLf
	msg = msg & "   Daytime Phone: (" & Request.Form("ReferenceDayArea3") & ") " & Request.Form("ReferenceDayPhone3") & " ext. " & Request.Form("ReferenceDayExt3") &  vbCrLf
	msg = msg & "     Years Known: " & Request.Form("ReferenceYearsKnown3") & vbCrLf & vbCrLf
	msg = msg & "EDUCATIONAL BACKGROUND" & vbCrLf & vbCrLf
	msg = msg & "              High School: " & Request.Form("HighSchool") & vbCrLf
	msg = msg & "Number of years completed: " & Request.Form("HSYears") & vbCrLf
	msg = msg & "         Did you graduate? " & Request.Form("HSGraduate") & vbCrLf
	msg = msg & "          Course of study: " & Request.Form("HSStudy") & vbCrLf & vbCrLf
	msg = msg & "                  College: " & Request.Form("College") & vbCrLf
	msg = msg & "Number of years completed: " & Request.Form("ColYears") & vbCrLf
	msg = msg & "         Did you graduate? " & Request.Form("ColGraduate") & vbCrLf
	msg = msg & "                    Major: " & Request.Form("ColMajor") & vbCrLf
	msg = msg & "                   Degree: " & Request.Form("ColDegree") & vbCrLf
	msg = msg & "          Course of study: " & Request.Form("ColStudy") & vbCrLf & vbCrLf
	msg = msg & "                    Other: " & Request.Form("OthSchool") & vbCrLf
	msg = msg & "Number of years completed: " & Request.Form("OthYears") & vbCrLf
	msg = msg & "         Did you graduate? " & Request.Form("OthGraduate") & vbCrLf
	msg = msg & "          Course of study: " & Request.Form("OthStudy") & vbCrLf & vbCrLf
	msg = msg & "How Did You Hear About Us: " & Request.Form("HowHear") & vbCrLf & vbCrLf
	msg = msg & "APPLICANT STATEMENT" & vbCrLf
	msg = msg & "I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct." & vbCrLf & "I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (1) cancel further consideration of this application, or (2) immediately discharge me from the employers service whenever it is discovered." & vbCrLf & "I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me." & vbCrLf & "I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law." & vbCrLf & "I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application." & vbCrLf & "If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in written and signed by the employers president." & vbCrLf & "I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard." & vbCrLf & vbCrLf
	msg = msg & "DO NOT SUBMIT THIS FORM UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT." & vbCrLf & vbCrLf
	msg = msg & Agree & " I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement." & vbCrLf
	msg = msg & "Name: " & Request.Form("Name") & vbCrLf & vbCrLf


'NEW HOST

sendUrl="http://schemas.microsoft.com/cdo/configuration/sendusing"
smtpUrl="http://schemas.microsoft.com/cdo/configuration/smtpserver"

' Set the mail server configuration
Set objConfig=CreateObject("CDO.Configuration")
objConfig.Fields.Item(sendUrl)=2 ' cdoSendUsingPort
objConfig.Fields.Item(smtpUrl)="relay-hosting.secureserver.net"
objConfig.Fields.Update

' Create and send the mail
Set objMail=CreateObject("CDO.Message")

' Logic
SendToCC = EmailAddress
IF LocationsApplied = "..." Then
SendTo = "[email protected]"
StoreTestLink = "http://www.ondemandassessment.com/apply.php?id=4GAn9%2BNQgRw%3D&a=l7GtMXUGn4w%3D"
Else If LocationsApplied = "Brenneman Farm, VA" Then
SendTo = "[email protected]"
StoreTestLink = "http://www.ondemandassessment.com/apply.php?id=4GAn9%2BNQgRw%3D&a=l7GtMXUGn4w%3D"
Else If LocationsApplied = "La Promenade, VA" Then
SendTo = "[email protected]"
StoreTestLink = "http://www.ondemandassessment.com/apply.php?id=4GAn9%2BNQgRw%3D&a=l7GtMXUGn4w%3D"
Else If LocationsApplied = "Chesterfield, MO" Then
SendTo = "[email protected]"
StoreTestLink = "http://www.ondemandassessment.com/apply.php?id=yLNS6ErS86M%3D&a=bMsIrSNx/9A%3D"
Else
SendTo = "[email protected]"
StoreTestLink = "http://www.ondemandassessment.com/apply.php?id=6WqtAKAjlDI%3D"
End IF
End IF
END IF

Set objMail.Configuration=objConfig
objMail.From="[email protected]"
objMail.ReplyTo="[email protected]"
objMail.To=SendTo
objMail.CC=SendToCC
objMail.Subject="Employment Application"
objMail.TextBody=msg
objMail.Send

End If

%>
<html>

<head>
<meta content="IE=EmulateIE7" http-equiv="X-UA-Compatible">
<meta content="General" name="rating">
<meta content="EN-US" name="MS.LOCALE">
<meta content="index,follow" name="robots">
<meta content="http://www.massageluxe.com" name="URL">
<meta content="31 days" name="revisit-after">
<meta content="TRUE" name="MSSmartTagsPreventParsing">
<meta content="MassageLuxe" name="Title">
<meta content="Our mission at MassageLuxe is to deliver the highest quality massage by providing a comfortable, relaxing, and luxurious environment to all of our clients. MassageLuxe offers many different types of massage." name="description">
<meta content="massage, massage therapy, couples massage, massage membership, swedish massage, deep tissue, relaxation, gift cards, massageluxe, relax, membership, members" name="keywords">
<title>Massageluxe - Application Thank You</title>
<link href="favicon.ico" rel="shortcut icon">
<link href="css/style.css" rel="stylesheet" type="text/css">
<link href="favicon.ico" rel="shortcut icon">
<style type="text/css">
.style18 {
	background-image: url('images/ML-Banner.jpg');
	text-align: center;
}
.style19 {
	background-image: url('images/Navigation/Careers-Nav.jpg');
}
.style20 {
	background-image: url('application_thankyou.asp');
}
.style40 {
	border-width: 0;
	font-size: 16pt;
}
.style44 {
	text-align: center;
	color: #2A7782;
	font-family: Arial, Helvetica, sans-serif;
	font-size: 10pt;
}
.style49 {
	background-image: url('images/Locations/Location_850.jpg');
}
.style46 {
	color: #000000;
}
.style54 {
	border-width: 0px;
	font-size: 16pt;
}
.style26 {
	color: #FFFFFF;
	font-family: Arial, Helvetica, sans-serif;
	font-size: 8pt;
}
.style48 {
	color: #B6A790;
	font-size: 8pt;
	font-family: Arial, Helvetica, sans-serif;
	font-weight: bolder;
}
.style41 {
	color: #FFFFFF;
	font-size: 8pt;
	font-family: Arial, Helvetica, sans-serif;
	font-weight: bolder;
}
.style22 {
	color: #FFFFFF;
	font-size: 10pt;
	font-family: Arial, Helvetica, sans-serif;
	font-weight: bolder;
}
.style55 {
	color: #2A7782;
}
</style>
</head>

<body style="margin: 0px; font-family: Arial, Helvetica, sans-serif;">

<div align="center">
	<font face="Georgia">
	<div align="center">
		<table id="table1" border="0" cellpadding="0" cellspacing="0" width="827px">
			<tr>
				<td class="style18" style="height: 140px;" valign="top">
				<a href="default.htm">
				<img alt="MassageLuxe" class="style40" height="135px" src="images/clrBanner.gif" width="815px"></a></td>
			</tr>
			<tr>
				<td class="style19" style="height: 4;">
				<map id="FPMap1" name="FPMap1">
				<area coords="714, 4, 826, 33" href="Franchise.htm" shape="rect">
				<area coords="509, 4, 593, 33" href="Careers.htm" shape="rect">
				<area coords="604, 4, 702, 33" href="https://pconsite4.pconsite.com/CMS_MassageLuxe/POS/giftcards/onlinegiftcardcustomersearch.aspx" shape="rect" target="_blank">
				<area coords="404, 4, 499, 33" href="LocationsMO.htm" shape="rect">
				<area coords="306, 4, 392, 33" href="AboutUs.htm" shape="rect">
				<area coords="179, 4, 293, 33" href="Memberships.htm" shape="rect">
				<area coords="82, 4, 166, 33" href="Services.htm" shape="rect">
				<area coords="0, 4, 68, 33" href="default.htm" shape="rect">
				</map>
				<img alt="MassageLuxe" class="style54" height="39px" src="images/ClearMenu.gif" usemap="#FPMap1" width="827px"></td>
			</tr>
		</table>
	</div>
	</font></div>
<table id="table2" align="center" cellpadding="0" cellspacing="0" class="style20" style="width: 827px; height: 850px">
	<tr>
		<td valign="top">
		<table align="left" cellpadding="10" cellspacing="10" class="style49" style="width: 827px; height: 850px">
			<tr>
				<td class="style44" style="height: 375px" valign="top">
				<table align="center" cellpadding="10" cellspacing="0" style="width: 80%">
					<tr>
						<td class="style20"><span lang="en-us">
						<span class="style27"><strong>Application for Employment</strong></span></span></td>
					</tr>
					<tr>
						<td><font face="Tahoma"><b>
						<div align="center">
							<table id="table9" border="0" cellspacing="1" height="148" width="500">
								<tr>
									<td height="40"><b><font size="2">THANK YOU!</font></b></td>
								</tr>
								<tr>
									<td height="40"><font face="Tahoma"><b>
									<font size="2">Your application has been sent 
									successfully. We will be reviewing it soon, 
									and will contact you if we have any further 
									questions or comments.<br><br>
									<span class="style55">Please click the image 
									link below to complete a quick test.</span><br>
									<br>
									<a href="<%=StoreTestLink%>" target="_blank">
									<img alt="Criteria On Demand Assessment" height="70" src="images/CriteriaTestIcon.jpg" style="border-width: 0px" width="404"></a>
									</font></b></font>
									<p><font face="Tahoma"><b><font size="2">Thanks 
									again, <br><span lang="en-us">MassageLuxe</span> 
									Management</font></b></font></p>
									</td>
								</tr>
							</table>
						</div>
						</b></font></td>
					</tr>
				</table>
				</td>
			</tr>
			<tr>
				<td class="style44" valign="bottom"><span lang="en-us">
				<a href="contactus.asp"><span class="style26">CONTACT US</span></a><span class="style46">&nbsp;
				</span><span class="style48">|</span><span class="style41">
				</span><span class="style26">&nbsp;<a href="default.htm">HOME</a>&nbsp;
				<span class="style48">|&nbsp; </span></span></span>
				<a href="services.htm"><span class="style26">SERVICES</span></a><span class="style26">&nbsp;
				</span><span class="style48">|</span><span class="style41">
				</span><span class="style26">&nbsp;</span><a href="memberships.htm"><span class="style26">MEMBERSHIPS</span></a><span class="style26">&nbsp;
				</span><span class="style48">|</span><span class="style41">
				</span><span class="style26">&nbsp;<a href="AboutUs.htm">ABOUT US</a></span><br>
				<span class="style26"><a href="LocationsMO.htm">LOCATIONS</a>&nbsp;
				<span class="style48">|</span></span><span class="style22">
				</span><span class="style26">&nbsp;</span><a href="careers.htm"><span class="style26">CAREERS</span></a><span class="style26">
				</span><span class="style41">&nbsp;</span><span class="style48">|</span><span class="style26">&nbsp;
				</span>
				<a href="https://pconsite4.pconsite.com/CMS_MassageLuxe/POS/giftcards/onlinegiftcardcustomersearch.aspx" target="_blank">
				<span class="style26">GIFT CARDS</span></a><span class="style26">&nbsp;
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Answer : Classic ASP form to email sending empty email?

I would recommend that you throw the objects away as well at the end of the mail call

Set Objmail = Nothing

etc
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