J.C.J. SECURITY SERVICE
APPLICATION FOR NEW HIRE  

ALL POTENTIAL EMPLOYEES ARE EVALUATED WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER, NATIONAL ORIGIN, AGE, MARITAL OR VETERAN STATUS, THE PRESENCE OF A NON-JOB RELATED HANDICAP OR ANY OTHER LEGALLY PROTECTED STATUS.
 

Position Sought: 


How did you learn about this position? 


Name: 

 Date: 


Address: 


City: 

State: 

Zip: 


Home Phone: 


Office Phone: 


Other Phone: 


EMail Address: 

Social Security Number: 


On what date would you be available to work? 


Desired Wage/Salary $ 



Are you a U.S. citizen, or are you otherwise authorized to work in the U.S. without any restrictions? 

Yes

No


Have you ever been convicted of a felony? 

Yes

No


If Yes, please describe the circumstances: 



Have you ever been involuntarily terminated or asked to resign from any position of employment? 

Yes

No


If Yes, please describe the circumstances: 



If selected for employment, are you willing to submit to a pre-employment drug screening test? 

Yes

No


EDUCATION 

School Name 

Location 

Years Attended 

Degree Received 

Major 

Other training, certifications, or licenses held:

List other information pertinent to the employment you are seeking:

EMPLOYMENT 

(Most Recent First)

1. Employer: 

Job Title: 

Dates Employed: 

From: 

 To: 

  Prior position held within Company (if any): 

Address: 

City: 

 State: 

 Zip: 

Phone: 

Supervisor: 

 May we contact?: 

Yes

No

Starting Salary: 

Ending Salary: 

Duties Performed: 

Reason for Leaving: 

2. Employer: 

Job Title: 

Dates Employed:
  From: 

 To: 

  Prior position held within Company (if any): 

Address: 

City: 

 State: 

 Zip: 

Phone: 

Supervisor: 

 May we contact?: 

Yes

No

Starting Salary: 

Ending Salary: 

Duties Performed: 

Reason for Leaving: 

3. Employer: 

Job Title: 

Dates Employed:
  From: 

 To: 

  Prior position held within Company (if any): 

Address: 

City: 

 State: 

 Zip: 

Phone: 

Supervisor: 

 May we contact?: 

Yes

No

Starting Salary: 

Ending Salary: 

Duties Performed: 

Reason for Leaving: 

4. Employer: 

Job Title: 

Dates Employed:
  From: 

 To: 

  Prior position held within Company (if any): 

Address: 

City: 

 State: 

 Zip: 

Phone: 

Supervisor: 

 May we contact?: 

Yes

No

Starting Salary: 

Ending Salary: 

Duties Performed: 

Reason for Leaving: 

ACKNOWLEDGEMENT AND AUTHORIZATION 

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any application wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Signature: 

 Date: 


Submit