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Job Application
Job Application
premieresecuri
2023-08-31T18:45:55+00:00
Name and Contact Information
Name
(Required)
First
Last
Address (No PO Boxes Allowed)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Home Phone
Other Phone
Email
(Required)
Position Information
Have you ever applied for work with Premiere Security Services before?
Yes
No
Position you are applying for: (Hold down the Ctrl button to make multiple selections)
Security Guard
Site Director
Corporate Night Supervisor
Are you seeking full or part time work? (Hold down the Ctrl button to make multiple selections)
Full Time
Part Time
What days are you available to work? (Hold down the Ctrl button to make multiple selections)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What times are you willing to work? (Hold down the Ctrl button to make multiple selections)
Any Available Shift
Days Between 7:00am & 7:00pm
Swing Between 1:00pm & 1:00am
Night Between 7:00pm & 7:00am
If employed and you are under 18 can you furnish a work permit?
Yes
No
N/A
Do you have a valid drivers license?
Yes
No
Do you have reliable transportation?
Yes
No
Are you willing to travel up to 40 miles one way from your home to a job site?
Yes
No
What is your level of formal education?
Select
High School
Associate Degree
Bachelor's Degree
Graduate or Professional Degree
Some College
Other
What languages do you speak? (Hold down the Ctrl button to make multiple selections)
English
Chinese
French
German
Japanese
Spanish
Vietnamese
Other
Guard/Military Experience
Have you served in the US military?
Yes
No
If yes, please select which branch:
Select
Air Force
Army
Army National Guard
Coast Guard
Marine
Navy
If you served in a foreign military, enter country/branch:
Current status:
Select
Active
Active Reserve
Inactive
Inactive Reserve
Honorable Discharge
Other than Honorable
Dishonorable
License Information
Please indicate the Security Guard licenses you possess. Check all that apply.
VA Unarmed
VA Armed
MD Unarmed
MD Armed
DC SO
DC SPO Armed
DC SPO Unarmed
Legal Information
Have you ever been convicted of a misdemeanor or felony?
Yes
No
If you answered yes to being convicted of a misdemeanor or felony please explain:
The nature of security work is demanding physically and mentally. It requires walking for long periods of time, running, bike riding, lifting, pushing, pulling & bending. It also requires mental acuity in judgment, observation and memory, vision to see near & far and hearing others speak. Do you have any limitations that will prevent you from performing your duties & responsibilities in an emergency situation that may involve some or all of the physical and mental demands above?
Yes
No
If yes, please explain your limitations :
Premiere Protection Services maintains a crime and drug free work environment. To apply for a employment you acknowledge your willingness to submit to a criminal background check and an initial drug test and if employed to fingerprinting and random drug testing as a requirement for employment.
I agree
I do no agree
For purposes of compliance with The Immigration Reform and Control Act, are you legally eligible for employment in the United States? Under the Immigration Reform and Control Act of 1986, you will be required to fill out a certification verifying that you are eligible to be employed and verifying your identity. Further, you will be required to provide documentation to that effect should you be employed.
Yes
No
Employment History
May we contact your current employer?
Yes
No
Are there any employers you do not want us to contact? (Please list in the box to the right the names of any employers that we do no have your permission to contact.)
Current or Most Recent Employer Name:
City, State, Zip
Employer's Phone No.:
Immediate Supervisor's Full Name:
Start Date:
MM slash DD slash YYYY
End Date: (if currently employed leave blank)
MM slash DD slash YYYY
Current Salary: (hourly)
(00.00)
Your Job Duties & Responsibilities:
Reason for leaving:
Currently Employed
Let Go in a Reduction in Force
Quit
Left for Another Opportunity
Fired (No Reason)
Fired (for Cause)
Previous Employer 2 Name:
City, State, Zip
Employer's Phone No.:
Immediate Supervisor's Full Name:
Start Date:
MM slash DD slash YYYY
End Date:
MM slash DD slash YYYY
Ending Salary: (hourly)
(00.00)
Your Job Duties & Responsibilities:
Reason for leaving:
Let Go in a Reduction in Force
Quit
Left for Another Opportunity
Fired (No Reason)
Fired (for Cause)
Previous Employer 3 Name:
City, State, Zip
Employer's Phone No.:
Immediate Supervisor's Full Name:
Start Date:
MM slash DD slash YYYY
End Date:
MM slash DD slash YYYY
Ending Salary: (hourly)
(00.00)
Your Job Duties & Responsibilities:
Reason for leaving:
Let Go in a Reduction in Force
Quit
Left for Another Opportunity
Fired (No Reason)
Fired (for Cause)
Personal References
Reference 1 Full Name:
Phone No.
Reference 2 Full Name:
Phone No.
Reference 3 Full Name:
Phone No.
Signature
I hereby certify that all entries are true and complete, and I agree and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part of any employment in the service of Premiere Protection Services, Inc.. I understand that all information on this application is subject to verification and I consent to criminal history background checks. I also consent that you may contact references, former employers and educational institutions listed regarding this application. I further authorize Premiere Protection Services, Inc. to rely upon and use, as it sees fit, any information received from such contacts. Information contained on this application may be disseminated to other government and nongovernmental organizations or systems on a need-to-know basis for good cause shown as determined by law or Premiere Protection Services, Inc.
I have read and understand the above. (You MUST type in capital letters "YES" to continue) (*)
(Required)
I completed this application on: (*)
(Required)
MM slash DD slash YYYY
By clicking the SUBMIT button below I agree and understand that I am digitally signing this application for employment. Information about my computer and I.P. address are also being recorded with my consent.
Yes I agree to all the terms in this application for employment. (You MUST type in capital letters "YES" to continue) (*)
(Required)
And your Initials in this box: (*)
(Required)
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