Employment Application Form

If you are interested in employment with our company, please use the form below and one of our personnel specialists will be in touch with you.

Fields in BOLD are required.

Name:
Email Address:
Date Of Birth:
Social Securtiy #:
Date Available For Work:
Desired Position:
Desired Hours Per Week:
Address:
City/State/Zip:
Telephone:
Secondary Telephone:
Do you have reliable transportaion every day? Yes No
Drivers License #:
State Issuing Driver's License:
Have you ever been convicted of a felony? Yes No
If Yes: List all convictions by State, offense, date, and date of release
Are You A Verteran? Yes No
If Yes: Army
Navy
Air Force
Marine Corps
Coast Guard
Dates of Service:
How did you learn about Empolyer's Security, Inc?
Education
High School:
Did you graduate? Yes No GED
College/University:
Major:
Degree Earned:
Graduation Date:
Previous Employment
May we contact your current Employer? Yes No
Compay Name/ Telephone Dates of Employment Starting - Ending Pay Reason for Leaving
Do you know of any restrictions or difficulty you might experience in performing the requirements of the job for which you are applying? Yes No
If Yes Please Explain:
Can you use any of these pieces of
office equipment/software?
Microsoft Office Typewriter Fax
Photocopier PC/Mac

I certify that the answers I have given on this application for employment are true and correct to the best of my knowledge and belief. I understand and agree that any misrepresentation or false statement made by my on this application will be just cause for immediate disregard for consideration for, or termination from employment. I hereby grant Employer's Security, Inc., it's officers, agents and employees the absolute right to investigate any and all claims and statements made by me in this application, including verification of my prior employment, criminal history, residential history, mode of living and personal character and credit history. I further agree to, without reservation or evasion, provide any and all additional and ancillary information that may now or in future be required to substantiate the statements I have made on this application for employment. Further, I absolutely and completely agree to hold harmless Employer's Security, Inc., it's owners, employees, agents and officers from any and all liability, damage or adverse action, actual, real or financial, that may, now or in future, result from the substantiation or investigation of these claims.

If employed, I understand and agree that, as a continual condition of that employment, I will submit to any and all testing for truth verification or narcotic or alcoholic beverage use during working hours that Employer's Security, Inc., in the person of it's owners, officers, administration or authorized agents for this purpose, may deem necessary or desirable. Further, I understand and agree that any refusal to submit to such testing will result in immediate termination from employment.

Further, I agree and understand that these terms shall and/or will remain in effect during any and all such times that I may be employed in any capacity by Employer's Security, Inc., it's subsidiaries or partner organizations. Further, I understand that Employer's Security Inc. adheres to a policy of "employment at will", meaning that either I or Employer's Security, Inc. are free to terminate any and all employment relationships at any time, with or without notice to the other party and that no person operating under or without the color of authority has any authorization or power to make assurances or contractual agreements to the contrary.

Further, I understand that this application will be current for sixty (60) days from the date listed on the front and that after that point, I may be required to make subsequent applications in order to be considered for employment. Further, a submission of this form by electronic means constitutes my agreement to abide by, and my complete understanding of, all these aforementioned terms and conditions.

Signature (Type your Full Name):
Date: