Application Form

Protective Arms Security

EMPLOYER

POSITION APPLYING FOR

PERSONAL DATA

First Name*

MIDDLE NAME

Last Name

Email*

STREET ADDRESS AND/OR MAILING ADDRESS

CITY

STATE

ZIP

HOME TELEPHONE NUMBER

BUSINESS TELEPHONE NUMBER

CELLULAR TELEPHONE NUMBER

DATE YOU CAN START WORK

SALARY DESIRED

DO YOU HAVE A HIGH SCHOOL DIPLOMA OR GED?*

Yes No

POSITION INFORMATION - CHECK ALL THAT YOU ARE WILLING TO WORK

HOURS

Full Time Part Time

DAYS EVENINGS

Days Evenings

SELECT

Swing Graveyard Weekends

STATUS

Regular Temporary

ARE YOU AUTHORIZED TO WORK IN THE U.S. ON AN UNRESTRICTED BASIS? *

Yes No

HAVE YOU EVER BEEN CONVICTED OF A FELONY? (CONVICTIONS WILL NOT NECESSARILY DISQUALIFY AN APPLICANT FOR EMPLOYMENT.) YES NO IF YES, EXPLAIN: *

Yes No

IF YES EXPLAIN:

HAVE YOU BEEN TOLD THE ESSENTIAL FUNCTIONS OF THE JOB OR HAVE YOU BEEN VIEWED A COPY OF THE JOB DESCRIPTION LISTING THE ESSENTIAL FUNCTIONS OF THE JOB? *

Yes No

CAN YOU PERFORM THESE ESSENTIAL FUNCTIONS OF THE JOB WITH OR WITHOUT REASONABLE ACCOMMODATION?

Yes No

QUALIFICATIONS

Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, and military training.

SCHOOL NAME

DEGREE

ADDRESS/CITY/STATE

SCHOOL NAME

DEGREE

ADDRESS/CITY/STATE

SPECIAL SKILLS

List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.)

SKILLS

REFERENCES

Please list three professional references not related to you, with full name, address, phone number, and relationship. If you don’t have three professional references, then list personal, unrelated references.

NAME

ADDRESS/CITY/STATE

PHONE

RELATIONSHIP

NAME

ADDRESS/CITY/STATE

PHONE

RELATIONSHIP

NAME

ADDRESS/CITY/STATE

PHONE

RELATIONSHIP

WORK HISTORY

Start with your present or most recent employment and work back. Use separate sheet if necessary. (INCLUDE PAID AND UNPAID POSITIONS)

JOB TITLE #1

START DATE

END DATE

COMPANY NAME

SUPERVISOR’S NAME

PHONE NUMBER

CITY

STATE

ZIP

DUTIES

REASON FOR LEAVING

STARTING SALARY

ENDING SALARY

MAY WE CONTACT YOUR PRESENT EMPLOYER?

Yes No N/A

JOB TITLE #2

START DATE

END DATE

COMPANY NAME

SUPERVISOR’S NAME

PHONE NUMBER

CITY

STATE

ZIP

DUTIES

REASON FOR LEAVING

STARTING SALARY

ENDING SALARY

SOCIAL SECURITY

BIRTHDATE

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 the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application. I acknowledge and understand that the company is an “at will” employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.

Application Form

Protective Arms Security

PERSONAL DATA

POSITION INFORMATION - CHECK ALL THAT YOU ARE WILLING TO WORK

QUALIFICATIONS

SPECIAL SKILLS

REFERENCES

WORK HISTORY