UPS Store Employment Application 

First Name
Last Name
Middle Initial
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

 

 Date

-- mm/dd/yy

Date of Birth
Sex Male Female
SS #

Type of employment desired:

Full Time
Part Time
Seasonal
If currently employed, may we contact your employer?

Yes
No

Are you legally eligible for employment in this country?

Yes
No

Have you been employed at The UPS Store before?

Yes
No

Are you available to work overtime if required?

Yes
No

Have you been convicted of a felony in the last seven (7) years?

Yes
No
EDUCATIONAL BACKGROUND
List previous three (3) educational institutions attended, beginning with the most recent.
School City State Graduate Degree Earned
Yes   No
Yes   No
Yes   No

EMPLOYMENT BACKGROUND
Provide the following information beginning with the most recent employer.
Employer
Supervisor
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
 Phone
FAX
E-mail

Job Title:


Employed From

To


Starting Salary Per

Ending Salary Per


Responsibilities
 

Reason For Leaving
 

 

Employer
Supervisor
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
 Phone
FAX
E-mail

Job Title:


Employed From

To


Starting Salary Per

Ending Salary Per


Responsibilities
 

Reason For Leaving
 

 

Employer
Supervisor
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
 Phone
FAX
E-mail

Job Title:


Employed From

To


Starting Salary Per

Ending Salary Per


Responsibilities


Reason For Leaving

 

REFERENCES
List the name, relationship, number of years acquainted, and phone number of three references.
First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone
FAX
E-mail
First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone
FAX
E-mail
First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone
FAX
E-mail

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

I authorize The UPS Store 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