Application for Employment                                              

 

Name                                                                                                                    Date                                                     

                                Last                                               First                                                   Middle

Address                                                                                                                                                                               

                Street                                                       City                                         State                        Zip Code

Telephone #   (       )                                             Other Phone #   (       )                                   

 

Social Security #                                                 Referred by                                                    

 

 

Position(s) applied for                                                                  Date available                                    

 

Type of employment desired Full-Time Part-Time Temporary Seasonal Educational Co-Op

 

Salary desired                If currently employed, may we contact your employer?  Yes     No

 

Are you legally eligible for employment in this country?  Yes     No

 

If you are under 18 and it is required, can you furnish a work permit?  Yes     No

 

Are you available to work overtime if required?  Yes     No

 

Have you applied with MBE/The UPS Store before?  Yes     No

 

Have you been employed at MBE/The UPS Store before?  Yes     No

If yes, when?                             and at what location?               

 

Do you have any friends or family employed at this location?  Yes     No

 

Have you been convicted of a crime in the last seven (7) years?  Yes     No

If yes, please explain                                                                                                                

                                                                                                CONVICTION WILL NOT NECESSARILY BE A DISQUALIFICATION FOR EMPLOYMENT.

 

EDUCATIONAL BACKGROUND

List previous three (3) educational institutions attended, beginning with the most recent.

 

 

 

 

DEGREE(s)/DIPLOMA(s)

SCHOOL

CITY, STATE

GRADUATED?

EARNED

 

 

    Yes     No

 

 

 

    Yes     No

 

 

 

    Yes     No

 

 


EMPLOYMENT BACKGROUND

Provide the following information beginning with the most recent employer.

 

EMPLOYER

TELEPHONE

DATES EMPLOYED

SUMMARIZE THE TYPE OF WORK

 

(      )

FROM

TO

PERFORMED AND JOB RESPONSIBILITIES

ADDRESS

 

 

 

 

 

 

 

 

 

JOB TITLE

 

HOURLY RATE/SALARY

 

 

 

STARTING

 

IMMEDIATE SUPERVISOR AND TITLE

 

$

per

 

 

 

 

 

 

REASON FOR LEAVING

 

HOURLY RATE/SALARY

 

 

 

FINAL

 

MAY WE CONTACT FOR REFERENCE?

 

$

per

 

         Yes         No         Later

 

 

 

 

EMPLOYER

TELEPHONE

DATES EMPLOYED

SUMMARIZE THE TYPE OF WORK

 

(      )

FROM

TO

PERFORMED AND JOB RESPONSIBILITIES

ADDRESS

 

 

 

 

 

 

 

 

 

JOB TITLE

 

HOURLY RATE/SALARY

 

 

 

STARTING

 

IMMEDIATE SUPERVISOR AND TITLE

 

$

per

 

 

 

 

 

 

REASON FOR LEAVING

 

HOURLY RATE/SALARY

 

 

 

FINAL

 

MAY WE CONTACT FOR REFERENCE?

 

$

per

 

         Yes         No         Later

 

 

 

 

EMPLOYER

TELEPHONE

DATES EMPLOYED

SUMMARIZE THE TYPE OF WORK

 

(      )

FROM

TO

PERFORMED AND JOB RESPONSIBILITIES

ADDRESS

 

 

 

 

 

 

 

 

 

JOB TITLE

 

HOURLY RATE/SALARY

 

 

 

STARTING

 

IMMEDIATE SUPERVISOR AND TITLE

 

$

per

 

 

 

 

 

 

REASON FOR LEAVING

 

HOURLY RATE/SALARY

 

 

 

FINAL

 

MAY WE CONTACT FOR REFERENCE?

 

$

per

 

         Yes         No         Later

 

 

 

 

EMPLOYER

TELEPHONE

DATES EMPLOYED

SUMMARIZE THE TYPE OF WORK

 

(      )

FROM

TO

PERFORMED AND JOB RESPONSIBILITIES

ADDRESS

 

 

 

 

 

 

 

 

 

JOB TITLE

 

HOURLY RATE/SALARY

 

 

 

STARTING

 

IMMEDIATE SUPERVISOR AND TITLE

 

$

per

 

 

 

 

 

 

REASON FOR LEAVING

 

HOURLY RATE/SALARY

 

 

 

FINAL

 

MAY WE CONTACT FOR REFERENCE?

 

$

per

 

         Yes         No         Later

 

 

 

 

 COMMENTS INCLUDING EXPLANATION OF ANY GAPS IN EMPLOYMENT:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                

REFERENCES

List the name, relationship, number of years acquainted, and phone number of three references. (No relatives please).

 

 

 

YEARS

PHONE

NAME

RELATIONSHIP

ACQUAINTED

NUMBER

 

 

 

         (        )

 

 

 

         (        )

 

 

 

         (        )

 

 

 

I certify that all the information I have provided is true, complete and correct.

 

I authorize Mail Boxes Etc. to investigate all statements contained on this application. I understand that any misrepresentation or omission of facts called for is cause for immediate disqualification and/or if employed, immediate dismissal.

 

Furthermore, I understand and agree that if employed, I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same rights to terminate my employment at any time, with or without prior notice, except as may be required by law. This application does not in any way constitute an agreement or contract for employment.

 

I understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States.

 

 

Applicant’s Signature                                                                                          Date