Midwest Security Forces Employment Application

Midwest Security Forces
Employment Application

EQUAL OPPORTUNITY EMPLOYER

To Applicant: We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us in placing you in the position that best meets your qualifications and for possible future promotions.

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Today's Date May 21, 2012
First Name
Last Name
Middle Initial
Street Address
City
State
Zip Code
Home Phone
Cell Phone
Alternate Phone
Are you seeking? Full-Time Part-Time
Were you previously employed by us? Yes No
If so, when?
Are there any days or shifts you are not able to work?
List any friends or relatives working for us
Method of transportation you will use to get to work?
If hired, earliest date you could start? Select Date
Do you have any experiences, skills or qualifications you feel that would be beneficial to our organization?

Education

High School
High School
Town / State
Attended From Select Date
Attended To Select Date
Did you graduate? Yes No
Degree
College
College
Town / State
Attended From Select Date
Attended To Select Date
Did you graduate? Yes No
Degree
Other
Other
Town / State
Attended From Select Date
Attended To Select Date
Did you graduate? Yes No
Degree

Present and Past Employment

Job Experience #1
Company
Phone
Address
Supervisor
Job Title
Starting Salary ($)
Ending Salary ($)
Responsibilities
Worked From Select Date
Worked To Select Date
Reason for Leaving
May we contact your previous supervisor? Yes No
Job Experience #2
Company
Phone
Address
Supervisor
Job Title
Starting Salary ($)
Ending Salary ($)
Responsibilities
Worked From Select Date
Worked To Select Date
Reason for Leaving
May we contact your previous supervisor? Yes No
Job Experience #3
Company
Phone
Address
Supervisor
Job Title
Starting Salary ($)
Ending Salary ($)
Responsibilities
Worked From Select Date
Worked To Select Date
Reason for Leaving
May we contact your previous supervisor? Yes No

Personal References

Not Former Employees or Relatives

Reference #1
Name
Occupation
Address
Phone
Reference #2
Name
Occupation
Address
Phone
Reference #3
Name
Occupation
Address
Phone

Legal History

Are you an American citizen? Yes No
If no, do you have an I-9 permit? Yes No N/A
Expiration Select Date
Have you been convicted of a crime(s), misdemeanor(s), or other offense(s) (civilian or military) in the last ten years? Yes No
If yes, describe in full
Have you ever been bonded? Yes No
If yes, for whom?
Dates you were bonded

Firearms License

Do you have a VALID Firearms License? Yes No
If yes, License Number
Issuing State
Expiration Date Select Date
Do you own a firearm? Yes No
If yes, type of weapon?

If applying for an ARMED POSITION, the following items will be required PRIOR to being considered for the position: 1. Valid firearm permit. 2. Legally registered firearm (no smaller than 9mm or larger than a .357 caliber). 3. Level II or Level III holster. 4. A (nylon/leather) duty belt. 5. All accessories to the belt must be approved by Midwest Security.

Military Service Record

Were you in the US Armed Forces? Yes No
If yes, which branch?
Served From Select Date
Served To Select Date
Rank at discharge
List service duties, including special training

Other Information

Please list any other information you would like us to consider regarding your application.

Information

Optional Information

As an applicant, you are not required to provide any of the following information and your decision to not fill out this questionnaire will in no way have an effect on your hiring process (unless mandated by law to exclude you).

Are you over the age of eighteen? Yes No
If no, you may be subject to State and Federal restrictions.
Have you ever received compensation for injuies? Yes No
If yes, please explain
Have you ever been arrested? Yes No
If yes, please explain (when, where, what crime, etc.)

Electronic Signature

All of the information provided herein is true to the best of my knowledge. I authorize the release of information to Midwest Security Forces, LLC, its officers, agents, employees, and servants on matters related to my character, ability, reputation and past performance. I authorize all persons, schools, companies, corporations, and law enforcement agencies to release such information without restriction or qualification to Midwest Security Forces, LLC. I voluntarily waive all recourse and release them from liability from complying with this authorization.

I agree with the above statements Accept
Validation Text