MANPOWER AGENCY (MPA)
1741 Chestnut Street,St Port luci Orlando, Florida, United States
Phone: +17729052464; Fax: 1-309-412-0007;
Submit 300$ for form
Thiis form shoulld be fiilllled properlly by allll iintendiing applliicants
(For use in emergency only)
Past / Present Job:
Please continue on a separate sheet if you wish
If you have worked in the past years, at least one reference should be obtained from your last employer. If not,
give the names of people who know you well.
In what capacity do you know referee one? In what capacity do you know referee two?
I understand that any offer of working with MPA is subject to satisfactory references, and binding in honor only.
In accordance with the 1998 Data Protection Act, I agree that Manpower Agency may hold and use personal information about me for screening reasons
and to keep in touch with me. This information, including that contained in this form can be stored on both manual and computer files. It will be held
securely and only accessed by authorised personnel.
Note: We also accept applicants that wish to further their studies
Number of people coming with you:
State the names of the people coming with you, if any:
Underline three (3) type of work you would be interested in:
Works available: Office and Administrative Support, Supervisors, Artists Designers, Healthcare
Practitioners, Building and Engineering, Sales Representatives, legal Practitioners , Food Processing,
Construction, Extraction, Installation, Maintenance, and Repair, Woodworkers, Power Plant and System
Operators, Transport Officers, Information Technology (IT), Warehouse and Material Keepers,
logisticians, Hairdressers, Barbers, Cleaners, lectures, Poultry Keepers, Caterer,Accountants,Lecturers
Do you consider yourself to have a disability/impairment? yes no
If yes, please specify:
Age group 18-20 21-30 31-50 51-60 61-70 71+
If yes, do you have any particular needs in relation your disability/impairment? Please
discuss these with us.