EMPLOYMENT APPLICATION

First Name

Middle Name

Last Name

Date of Birth

Street Address

City

Zip

Social Security Number

Phone

Have you ever applied for employment with the Superior One Protective Services?*
YesNo

If Yes, When

Do you possess a valid Security Guard Card issued by the State of California BSIS
YesNo

Guard Card Number

When can you start?

Will you work overtime if asked?
YesNo

Position Desired

Payment Desired Per Hour

Are you legally eligible for employment in the United States of America?
YesNo

List any special training, skills, or certifications (Language, Office Equipment. Computer Skills, etc,)

Membership in Professional or Civic Organizations Past or Present (Exclude those which may disclose your race, color, religion, or National origin)

EDUCATION:

Elementary School

# of Years Completed

Did You Graduate

High School

# of Years Completed

Did You Graduate

Certificate Earned

Trade School

Course of Study

# of Years Completed

Did You Graduate

Certificate Earned

College

Course of Study

# of Years Completed

Did You Graduate

Certificate Earned

MILITARY:

Note: Complete this section ONLY if you have served in the Armed Forces of The United States

Branch of Service

From

Type of Discharge

Rank At Discharge

Describe Duties and Special Training

Are you in the Reserves or National Guard?
YesNo

Reserve or Guard Unit/Location

If you are in the Reserves or National Guard, please provide the Dates and Time you will need off on Weekend Drills and for Summer Training

The information requested in this section is needed for legally permissible reasons., including without limitation, National Security Considerations. A Legitimate Occupational Qualification or Business Necessity.

The Civil Rights Act of 1964 Prohibits Discrimination in Employment because of Race, Color, Religion, Sex, or National Origin. Federal Law also prohibits Discrimination on the basis of Age with respect to certain individuals.

The Law in most States also prohibits some or all of the above types of Discrimination as well as some additional types such as Discrimination based upon Ancestry, Marital Status, Physical or Mental Handicap or Disability

Superior One Protective Services: IS AN EQUAL EMPLOYMENY OPPORTUNITY EMPLOYER.

Employment History Please give an accurate and complete history of full-time and part-time employment for the past 10 years. Employment is subject to verification. May we contact the employers below?
YesNo

Company Name #1

Street Address

City

State

Zip

Start

End

Hourly pay

Supervisor Name

Telephone Number

Job Title/Duties

Reason for leaving

Are you still employed?
YesNo

Company Name #2

Street Address

City

State

Zip

Start

End

Job Title/Duties

Telephone Number

Hourly pay

Supervisor Name

Reason for leaving

Are you still employed?
YesNo

Company Name #3

Street Address

City

State

Zip

Start

End

Hourly pay

Supervisor Name

Telephone Number

Job Title/Duties

Reason for leaving

Are you still employed?
YesNo

Company Name #4

Street Address

City

State

Zip

Start

End

Hourly pay

Supervisor Name

Telephone Number

Job Title/Duties

Reason for leaving

Are you still employed?
YesNo

Have you ever used any other Names in the past for School, Employment, or Other Reasons?
YesNo

If YES, list all names used below

Gender
FemaleMaleNon-BinaryPrefer Not To Answer

Height

Weight

If No what Country is your Citizenship?

Are you a Citizen of the United States?
YesNo

What is your Immigration Status?

Resident Alien Card#

If Yes, Explain below

Have you ever been bonded?
YesNo

If Yes, Explain below

Do you have any Relatives employed with the Superior One Protective Services?
YesNo

If yes, please list them below

Have you ever received Workers Compensation or Disability Payments?
YesNo

If Yes, Explain below

DO YOU HAVE ANY PHYSICAL LIMITATIONS THAT PRECLUDE YOU FROM PERFORMING CERTAIL JOBS OR DUTIES?
YesNo

If Yes, Explain below

The information provided in this application for employment is True, Correct, and Complete. If employed, any misstatements or omissions in this Application or Interview may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the Employer to continue to employ me in the future. If the Superior One Protective Services. decides to engage an Investigative Consumer Reporting Agency to acquire a report on my credit and personal history, I authorize the Superior One Protective Services, to do so. If a report is obtained, the Superior One Protective Services. must provide at my request, the name and address of the Agency so I may obtain from them the nature and substance of the information contained in the report