Name *
Address *
City *
State *
Zip *
Home Phone *
Cell Phone
Alternate Phone
Email *
Are you over 18?	YesNo
Are you authorized to work in the US on an unrestricted basis?	YesNo

How did you learn about L & D Mail Masters?

Have you worked here before?	YesNo
If yes, when?
Who was supervisor?
Preferred Shift	1st Shift2nd Shift

Are there any hours/shifts/days you cannot work?

Are you willing to work overtime as required?	YesNo
Have you ever been convicted of a felony?	YesNo

If "yes" to a conviction*, please describe the conditions:

* A conviction will not necessarily disqualify an applicant for employment.

Education	Name of School	Graduated	Major	Diploma/Degree
High School		YesNo
College		YesNo
Other		YesNo

In addition to your work history, what other experiences, skills, or training would especially fit you for work with our company?

What Department are you applying for?	Production Accounting Computer/Data Processing Human Resources Sales Graphic Design/Media Maintenance Networking Programming
Desired Wage/Salary
When can you start?
Personal References:
Name
Relationship
Occupation
Telephone
Name
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Occupation
Telephone
Name
Relationship
Occupation
Telephone
Employment History:
May we contact your present employer?	YesNo
May we contact your previous employers?	YesNo
Most Recent Employer
Address
Date Started
Starting Salary
Starting Position
Date Left
Ending Salary
Ending Position
Reason For Leaving
Previous Employer
Address
Date Started
Starting Salary
Starting Position
Date Left
Ending Salary
Ending Position
Reason For Leaving
Previous Employer
Address
Date Started
Starting Salary
Starting Position
Date Left
Ending Salary
Ending Position
Reason For Leaving

APPLICANTS CERTIFICATION AND AGREEMENT

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize L & D Mail Masters to make an investigation of any facts set forth in this application.

I understand that employment with L & D Mail Masters is "at will" which means that either I or L & D Mail Masters can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager, or executive of L & D Mail Masters, other than the President has any authority to alter the foregoing.

Thank you for your interest in L & D Mail Masters!

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