New Application -

Employment Application for Security Officer

Please complete this online application in its entirety before submitting it. If there are any errors unrecognized after you submit you will have to complete and resubmit another application. Make sure you complete this application with all honesty and integrity to the best of your knowledge.

Last Name

First Name

Middle

Date

Address

City

State

Zip Code

Phone Number

Alternate Number

Social Security Number

License Number

Issuing State

Date of Birth

Position Applying For

Type of Work Desired

Full-Time Part-Time Temporary/Contract

Will you work Overtime?

Yes No

Date Available to Start

If hired, can you provide proof that you are authorized AND of legal age to work in U.S.

Yes No

Emergency Contact Person

Emergency Contact Number

Name of Nearest Relative

Nearest Relative Number

Did you have a Highschool Diploma or G.E.D.?

Yes No

Name of School

Course of Study

Did you attend a Business/Technical School?

Yes No

Name of Business/ Technical School

Degree or Certificate Name

Please List any other Certifications, Degrees or Skills you obtain that may relate to the position you are applying for.

Have you had First-Aid Training?

Yes No

Date First-Aid Training was Completed

Have you had CPR Training?

Yes No

Date CPR Training was Completed

Current Employer

Employer Number

Address

City

State

Zip Code

Position Held

From

Starting/Ending Salary

Supervisor Name

Reason For Leaving

Previous Employer 1

Employer Number

Address

City

State

Zip Code

Position Held

From

Starting/Ending Salary

Supervisor Name

Reason For Leaving

Previous Employer 2

Employer Number

Address

City

State

Zip Code

Position Held

From

Starting/Ending Salary

Supervisor Name

Reason For Leaving

Have you Served in the U.S. Armed Services?

Yes No

Branch?

Start Date

End Date

Rank/Rate at Discharge

Type of Service

Type of Discharge

Special Training/Experience Received in the U.S. Armed Services

Draft Status

Reserve Status

Have you ever been CONVICTED of a criminal offense?

Yes No

Do you currently have any criminal actions pending in which you are the Defendant?

Yes No

Are you currently on Probation or Parole?

Yes No

If "YES" to ANY of the above questions, please explain the nature of the offense and provide the date of the offense and the county and state in which it occurred.

Personal Reference

Number

Occupation

Relationship

Personal Reference 2

Number

Occupation

Relationship

Personal Reference 3

Number

Occupation

Relationship

Applicant Statement (Read and Ignitial Below)

I certify that this employment application was completed by me and that all of the information on this application is true and correct to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of facts called for herein will result in my disqualification from further consideration or dismissal from employment if I am hired. I have reviewed the Authorization for Criminal Records Verification and Fingerprint Information and acknowledge that I understand the terms set forth therein. I understand that this employment application is not valid without my signature.

Ignitials

Date

Employment Application for Security Officer

Elevated Protection Group

614-412-4651

33 S. James Rd., #202, Columbus, Oh 43213

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