Employment Application Applicant Information * First Name Middle Name * Last Name * Address * City * State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY * Zip * Number of years at this address * Mobile Phone * Home Phone * Email Address * Birth Date Emergency Contact (to be contacted if you are involved in an emergency): * Contact Name * Relationship to you * Address * City * State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY * Zip * Mobile Phone * Home Phone Job Position Applied For: Position Armed Security Guard Unarmed Security Guard Other * Salary Desired (per month) Are you applying for a specific job posting? Yes No If yes, for which job are you applying? * Have you previously applied to our company? Yes No If yes, when? Are you at least 18 years old? Yes No * How will you get to work? What reasonable accommodation, if any, would you require? THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT. (OMIT THIS SECTION IF APPLYING WITHIN A STATE WHERE CRIMINAL HISTORY INQUIRIES ON EMPLOYMENT APPLICATIONS ARE PROHIBITED.) Have you ever received a traffic citation for any of the following: * Alcohol or drug related offences? Yes No * Reckless or careless driving? Yes No * Speeding 20 mph over the posted limit? Yes No * Have you ever been convicted in any court of a crime, sentenced to imprisonment for a term exceeding 1 year for that crime, and incarcerated as a result of that sentence for not less than 1 year? Yes No * Have you ever been charged with any felony offense? Yes No * Have you ever been convicted of an offense involving domestic violence or a crime of violence (such as battery or assault)? Yes No * Have you ever been charged with an offense involving alcohol or drugs? Yes No Explain all Yes answers: Applicant's Skills, Ability, or Skill Years of Experience Rating Microsoft Office Suite (Word, Excel, etc.) * Have you worked in Law Enforcement? Yes No Where How long Reason for leaving * Have you worked in the Private Security industry? Yes No * Do you have a Security Guard License? Yes - Armed Yes - Unarmed No If so, provide state and license numbers: * If No, have you applied for a Security Guard License? Yes - Armed Yes - Unarmed No When? Applicant Employment History List your current or most recent employment first. Employer Name Supervisor Name Address City State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Job Duties Reason for Leaving Dates of Employment (Month/Year) Employer Name Supervisor Name Address City State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Job Duties Reason for Leaving Dates of Employment (Month/Year) Employer Name Supervisor Name Address City State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Job Duties Reason for Leaving Dates of Employment (Month/Year) Employer Name Supervisor Name Address City State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Job Duties Reason for Leaving Dates of Employment (Month/Year) Military Service Branch Supervisor Name Address Job Duties Reason for Leaving Dates Served (Month/Year) Specialized Training Education College/University Address Phone Number Degree High School Address Phone Number * Graduated Yes No * GED Yes No Other Training (graduate, technical, vocational) Awards, Honors, Special Achievements References – Please provide 3 personal references, other than family members, who have known you for 5 years or more Name Address City * State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip * Phone Number Relationship Name Address City State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip * Phone Number Relationship Name Address City State Select a value AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip * Phone Number Relationship Please provide any other information that you believe should be considered: Other Information CERTIFICATION I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences immediate termination. I authorize Global Security Corporation to conduct criminal background checks, credit checks, and to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information to Global Security Corporation. I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS. * APPLICANT SIGNATURE * DATE * Word verification You must fill out all required fields
