Application for Employment

Equal access to programs, services and employment is available to all persons.                

PLEASE PRINT

Position applied for__________________________ Date of application_______________ 

Full LEGAL Name________________________ Date of Birth_____________________ Address____________________ City________________ State_________________ Zip___________ Telephone ________________________

Social Security Number_____________________ Best Time to call you at home_____________

Have you file an application here before? Yes _____  No _____ 

Have you been employed here before? Yes _____  No _____  If yes, give date_________________________

Are you legally eligible for employment in this country? Yes _____  No _____  

Date available for work________________  Type of employment desired: Full time______ Part time_____

Are you on lay-off subject to recall? Yes _____  No _____  

Will you re-locate if job requires? Yes _____  No _____ 

Will you travel if job requires? Yes _____  No _____  Have you ever been bonded?Yes _____  No _____ 

Have you been convicted of a felony and or misdemeanor (including traffic citations) in the last seven (7) years? Yes _____  No _____  (Such conviction may be relevant if job related, but does not bar you from employment).  If yes, please explain:___________________________________________________________

Are you currently or have you been ordered to pay child support pursuant to a court order? Yes _____  No _____   Driver’s License number___________________________ State___________________________

Are you able to meet the attendance requirements of the position? Yes _____  No _____ 

Educational Background

A.  Last three (3) schools attended, starting with most recent.  B.  List number of years completed.  C.  Indicate degree of diploma earned if any.  D.  Grade point average or class rank.  E.  Major and minor field of study.

A.  School

B. Years Completed

C. Degree Diploma

D.  GPA/Class Rank

E. Major

E. Minor

1.

 

 

 

 

 

2.

 

 

 

 

 

3.

 

 

 

 

 

List any foreign Language(s) you speak fluently_________________________________________________

 

References

List name and telephone number of three business/work references who are not related to you and not previous supervisors.  If not applicable, list three school or personal references who are not related to you.

Name

Telephone Number

Years Known

1.

 

 

2.

 

 

3.

 

 

List professional, trade, business or civic associations and any offices held.  (Exclude memberships which would reveal sex, race, religion, national origin, age, color, disability, or other protected status)

Organization

Offices Held

1.

 

2.

 

3.

 

List special accomplishments, publications, awards (exclude information which would reveal sex, race, religion, national origin, age, color, disability or other protected status)

 

 

 

 

List any additional information you would like us to consider.

 

 

 

 

Employment History

Employer                                                     Telephone

Dates Employed

Work performed/Job responsibilities.

                                             (     )

From:

To:

Address:

 

 

 

Job Title:

Hourly Rate/Salary

 

 

Starting

 

Immediate Supervisor/Title:

$

Per

 

Reason for Leaving:

Hourly Rate/Salary

 

 

Final

 

May we contact for reference? Yes_____ No_____

$

Per

 

Employer                                                     Telephone

Dates Employed

Work performed/Job responsibilities.

                                             (     )

From:

To:

Address:

 

 

 

Job Title:

Hourly Rate/Salary

 

 

Starting

 

Immediate Supervisor/Title:

$

Per

 

Reason for Leaving:

Hourly Rate/Salary

 

 

Final

 

May we contact for reference? Yes_____ No_____

$

Per

 

Employer                                                     Telephone

Dates Employed

Work performed/Job responsibilities.

                                             (     )

From:

To:

Address:

 

 

 

Job Title:

Hourly Rate/Salary

 

 

Starting

 

Immediate Supervisor/Title:

$

Per

 

Reason for Leaving:

Hourly Rate/Salary

 

 

Final

 

May we contact for reference? Yes_____ No_____

$

Per

 

Employer                                                     Telephone

Dates Employed

Work performed/Job responsibilities.

                                             (     )

From:

To:

Address:

 

 

 

Job Title:

Hourly Rate/Salary

 

 

Starting

 

Immediate Supervisor/Title:

$

Per

 

Reason for Leaving:

Hourly Rate/Salary

 

 

Final

 

May we contact for reference? Yes_____ No_____

$

Per

 

Employer                                                     Telephone

Dates Employed

Work performed/Job responsibilities.

                                             (     )

From:

To:

Address:

 

 

 

Job Title:

Hourly Rate/Salary

 

 

Starting

 

Immediate Supervisor/Title:

$

Per

 

Reason for Leaving:

Hourly Rate/Salary

 

 

Final

 

May we contact for reference? Yes_____ No_____

$

Per

 

Comments (including explanation of any gaps in employment)___________________________________

Skills and Qualifications – Summarize any special training, skills, licenses, certificates and/or characteristics of yourself that may qualify you for being able to perform job-related functions for the position you are applying

 

 

 

 

It is understood and agreed upon that any misrepresentation by me on this application will be sufficient cause for cancellation of this application and/or separation from the employer’s service if I have been employed.

I  understand that I may be requested to work 1st, 2nd or 3rd shift.  S.W.A.T. Patrol Security is a 24 hour service that works 365 days of the year.    Please initial here___________

I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information._____

The employer is an Equal Opportunity employer.  The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employment on a basis prohibited by local state or federal law. 

This application is current for only 60 days.  At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that just as I am free to resign at any time – 2 weeks noticed would be preferred.  The employer reserves the right to terminate my employment at any time, with or without cause and without prior notice.  I understand that no representative of the employer has the authority to make assurances to the contrary.______

I understand it is the company’s policy not to refuse to hire a qualified individual with a disability because of this person’s need for an accommodation that would be required by the ADA._____

Signature of Application

 

Date

 

I understand that I could be subject to work 1st, 2nd or 3rd shift  ___________ Applicant’s Initials

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