Please read the following carefull and sign below. Your e-signature is required to be considered for employment. It acknowledges you have read, understand, and agree to the information.

Applicant Statement (Please read carefull before signing)

I hereby certify that the information contained in this application is true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any misrepresentation, falsification or omission of information on this application or on any document used to secure employment shall be grounds for rejection of this application or immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby authorize UFOT, LLC to thoroughly investigate the information on my application, my references, credit history, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to UFOT, LLC all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release UFOT, LLC, my former employers and all other persons or entities form any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosures. UFOT, LLC adheres to a policy of at-will employment which recognizes that each employee and UFOT, LLC each retain the right to terminate the employment relationship and that the UFOT, LLC retains the right to modify an employees position or compensation at any time, with or without cause or notice. No one other than the President/CEO has the authority to make any binding promise or enter into any agreement inconsistent with UFOT, LLC�s at-will policy and any such agreement must be in writing and signed by both parties to be effective. As a condition of employment, all individuals offered a management position are required to submit to a pre-employment drug test.

Melrose Online Application

All fields marked with a * are required
PERSONAL
	Last Name:	*
	First Name:	*
	Middle Name:
	Social Security Number:	*
	Current Address:	*
	City & State:	*
	Zip Code:	*
	List any other name under which you have been employed:
	Telephone Number (including are code)	*
	Mobile / Other Number (including are code)
	Are You Elegible To Work In The U.S?	Yes No *
	English - Do You? (check all that apply)	Speak Read Write *
	Spanish - Do You? (check all that apply)	Speak Read Write *
JOB AND AVAILABILITY
	Position Applied For?	*
	Date Available For Work?	*
	Expected Wage?	*
	Will You Accept Part-Time? If Yes, How Many Hours Per Week?	- Yes No * -
	Type Of Employment Desired?	Full-Time Part-Time Temporary *
	Check Days Available:	Any Mon Teus Wed Thurs Fri Sat Sun *
	Check Shifts Available:	Any Morning AfterNoon Evening *
	Have You Ever Been Employed Here Before? If Yes, Give Dates: If Yes, Why Did You Leave?	- No Yes * - -
	Position Held:
	How Did You Find Out About This Job?
	Friends Or Relatives Empoyed Here:
EDUCATION Note: If required for position from which you are applying, a copy of your high school diploma/GED certificate will be required at time of employment.
	Did You Graduate From High School Or Receive A GED Certificate?	Yes No *
	Name Of School:
	City & State:
COLLEGE OR UNIVERSITY
	Name:
	City & State:
	Number Of Years Completed:	1 2 3 4
	Dates Attended:
	Did You Receive A Degree: If Yes, What Type:	- Yes No -
BUSINESS OR TECHNICAL SCHOOL
	Name Of School:
	City & State:
	Type Of Study:
	Dates Attended:
	Did You Complete The Program?	Yes No

	List Any Other Training Or Skills:
GENERAL INFORMATION AND REFERENCES
	Do You Have Arrangements For Transportation?	Yes No *
	If applying for Driver's Position: Type Of Valid Driver's License: Issuing State: Drivers License Number:	- - -
	Has You License Ever Been Suspended Or Revoked? If Yes, Why?	- No Yes -
	Have You Ever Been Convicted Of A Crime (other than minor traffic offenses) If Yes, Give Full Details Including Dates: (Conviction will not necessarily disqualify an applicant for emplyment)	No Yes *
	Will You Be Willing To Relocate If Job Requires It?	Yes No *
	Will You travel If Job Requires It?	Yes No *
	Day Lost From Work Durning Past 2 Years. (include reasons)
LIST REFERENCES WHO ARE NOT RELEATIVES
REFERENCE 1
	Name:
	Company Name & Address
	Position Held:
	Telephone Number (including are code)
REFERENCE 2
	Name:
	Company Name & Address:
	Position Held:
	Telephone Number (including are code)
REFERENCE 3
	Name:
	Company Name & Address:
	Position Held:
	Telephone Number (including are code)
PREVIOUS WORK EXPERIENCE
EMPLOYER 1
	Employer (Please include city and state)
	Telephone Number (include are code)
	Employed From:
	Employed To:
	Position Held:
	Supervisors Name:
	Starting Rate Of Pay:
	Ending Rate Of Pay:
	Job Duties (Please give brief description)
	Reason(s) For Leaving:
EMPLOYER 2
	Employer (Please include city and state)
	Telephone Number (include are code)
	Employed From:
	Employed To:
	Position Held:
	Supervisors Name:
	Starting Rate Of Pay:
	Ending Rate Of Pay
	Job Duties (Please give brief description)
	Reason(s) For Leaving
EMPLOYER 3
	Employer (Please include city and state)
	Telephone Number (include are code)
	Employed From:
	Employed To:
	Position Held:
	Supervisors Name:
	Starting Rate Of Pay:
	Ending Rate Of Pay
	Job Duties (Please give brief description)
	Reason(s) For Leaving:
IMPORTANT INFORMATION FOR YOU
Please read the following carefull and sign below. Your e-signature is required to be considered for employment. It acknowledges you have read, understand, and agree to the information. Applicant Statement (Please read carefull before signing) I hereby certify that the information contained in this application is true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any misrepresentation, falsification or omission of information on this application or on any document used to secure employment shall be grounds for rejection of this application or immediate discharge if I am employed, regardless of the time elapsed before discovery. I hereby authorize UFOT, LLC to thoroughly investigate the information on my application, my references, credit history, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to UFOT, LLC all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release UFOT, LLC, my former employers and all other persons or entities form any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosures. UFOT, LLC adheres to a policy of at-will employment which recognizes that each employee and UFOT, LLC each retain the right to terminate the employment relationship and that the UFOT, LLC retains the right to modify an employees position or compensation at any time, with or without cause or notice. No one other than the President/CEO has the authority to make any binding promise or enter into any agreement inconsistent with UFOT, LLC�s at-will policy and any such agreement must be in writing and signed by both parties to be effective. As a condition of employment, all individuals offered a management position are required to submit to a pre-employment drug test.
	Applicant's E-Sgnature: (Please type your full legal name)	*
	Date:	*

Melrose Online Application