MODEL MANAGEMENT SERVICE, INC.
d.b.a. FRIENDLY TRANSPORTATION & MESSENGER SERVICE
625 EAST ORANGE STREET
LANCASTER, PA 17602

Application for Employment
Note:
DOT Mandates
Pre-Employment
Drug Testing

Name:     Date/Time of Application:
Address:     Phone #:
City:     State:     Zip:     Soc. Sec #:

Position(s) Applied For:     Sedan     Van     Wheelchair     Any                      Drivers License #:
Available CDL Class:   Bus     Truck     Other                   State:

How Did You Hear About Us?

    Advertisement                                  Friend                                    Walk-In
    Employment Agency                        Relative                                 Other

  Have you ever filed an application with us before?                                                      No   Yes, date:
  Have You ever been employed with us before?                                                          No   Yes, date:
  Are you currently employed?                                                                                     No   Yes
  May we contact your present employer?                                                                    No   Yes
  Are you prevented from being lawfully employed in this country
    because of Visa or Immigration Status?*                                                                  No   Yes
    *Proof of Citizenship or Immigration Status will be required upon employment
  On what date would you be available for work?                                                         
  Are you available to work:                                                      Full Time     Part Time     Shift Work     Temp
  Are you currently on "lay-off" status and subject to recall?                                           No   Yes
  Can you travel if a job requires it?                                                                               No   Yes
  Have you been convicted of a felony within the last 7 years?*                                      No   Yes
    *Conviction will not necessarily disqualify an applicant from employment.
                                                                                                                                    If Yes, Please explain:
                                                                                                     
  Have your operating privileges ever been revoked?                                                     No   Yes
                                                                                                                                    If Yes, Please explain:
                                                                                                     
  Is there currently legal action pending against your driver's license?                              No   Yes
                                                                                                                                    If Yes, Please explain:
                                                                                                     
  How long have you been at your present address?                                                     
  If less than 3 years, list previous address:                                         
                                                                                                City:   State:   Zip:
  How long at previous address?                                                                                  
  Please list three personal refernces:                                                             1) Name: phone:
                                                                                                                   2) Name: phone:
                                                                                                                   3) Name: phone:
  In case of Emergency Contact:                                                                       Name: phone:

Education

  Name of School/College:         City:       State:
  Course of Study:         Years Completed:
  Did you Graduate?: No Yes       Degree or Diploma:
  Name of School/College:         City:       State:
  Course of Study:         Years Completed:
  Did you Graduate?: No Yes       Degree or Diploma:
  Name of School/College:         City:       State:
  Course of Study:         Years Completed:
  Did you Graduate?: No Yes       Degree or Diploma:

Employment Experience

  Start with your present or last job. Include any job-related military experience and volunteer activities. You may exclude
  organizations which indicate race, color, religion, gender, nation of origin, disabilities, or other protected status.

  Employer:   Dates Employed (from): (to):
  Address:   City:   State:   Zip:
  Phone #:   Job Title   Supervisor:   Hourly Rate/Salary:
  Work Performed:
  Reason for Leaving:
  Employer:   Dates Employed (from): (to):
  Address:   City:   State:   Zip:
  Phone #:   Job Title   Supervisor:   Hourly Rate/Salary:
  Work Performed:
  Reason for Leaving:
  Employer:   Dates Employed (from): (to):
  Address:   City:   State:   Zip:
  Phone #:   Job Title   Supervisor:   Hourly Rate/Salary:
  Work Performed:
  Reason for Leaving:

Applicant's Statement

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationships with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged, in writing, by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

                                                              By clicking the Submit button, I hereby agree to the terms above:

625 East Orange Street, Lancaster, PA 17602 | 1-800-795-FAST | (717) 392-2222 | FAX (717) 394-6937