Employment With Victory

Instructions

Application For Employment:

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

Please provide the following (*required)

First Name*

Last Name*

Address*

City*

State / Province*

Postal Code*

Phone*

Fax

Email*

Position Applied For

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General Information

Best time to contact you at home is:

Have you ever filed an application with us before?

	Yes
	No

Have you ever been employed with us before?

	Yes
	No

Do any of your friends or relatives, other than spouse work for Victory Worldwide Transportation?

	Yes
	No

Are you currently employed?

	Yes
	No

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?

	Yes
	No

What date are you available for work?

What is your desired salary range?

Are you currently on "lay-off" status and subject to recall?

	Yes
	No

Can you travel if a job requires it?

	Yes
	No

Do you have a Class A or B drivers license?

	Yes
	No

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Education

Name and Address of High School Attended:

Name and Address of College Attended:

Describe any specialized training, apprenticeship, skills and extra-curricular activities you have.

Describe any moving industry training you may have:

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Employment Experience

Start with your present or last job. You may exclude organizations which indicate race, color, religion, gender, national origin disabilities or other protected status

Employer

Address

Telephone Number

Job Title

Supervisor

Reason for leaving

Dates Employed

Hourly Rate / Salary

Work Performed

Employer

Address

Telephone Number

Job Title

Supervisor

Reason for leaving

Dates Employed

Hourly Rate / Salary

Work Performed

Employer

Address

Telephone Number

Job Title

Supervisor

Reason for leaving

Dates Employed

Hourly Rate / Salary

Work Performed

Employer

Address

Telephone Number

Job Title

Supervisor

Reason for leaving

Dates Employed

Hourly Rate / Salary

Work Performed

List professional, trade, business, or civic activities and offices held

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Additional Information

Other Qualifications- Summarize special job-related skills and qualifications acquired from employment or other experience.

Have you ever worked for a United Van Lines agent in the past?

	Yes
	No

Have you had training on the 400N tariff, United Van Lines HOD systems, Compusource Vans, or Microsoft Office? Please Explain

Please state any additional information you feel may be helpful to us in considering your application:

Please submit three professional and three personal references including name, address, phone number and relationship:

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