Employment

*PERSONAL INFORMATION*
All Field Are Required.

First Name	M.I.		Last Name
Telephone #
Cell Phone #
E-Mail
Do you possess a valid driver's license?

Present Address:
Street No.	City
State	Zip Code
How long at this address?

Previous Address:
Street and No.	City
State	Zip Code


Previous Address:
Street and No.	City
State	Zip Code

*EMPLOYMENT DESIRED*

Date you will be available for work?
Salary Desired? $
Are you currently employed?
If so, may we contact your employer?
If you have applied to this company before, please indicate when and position.
Do you seek full or part time employment?
Can you work nights? Can you work weekends?
Days and hours available for work:
Mon. Tues. Wed. Thurs. Fri. Sat. Sun.
Do you have a driver's license? Driver Lic. # State of issue
Operator? Commercial? (CDL) Chauffeur
What is your means of transportation to and from work?
Have you had any accidents in the last 3 years? How many?
Have you had any moving violations during the last 3 years? How many?
List other names or aliases you have used
If employed, can you provide proof of legal right to work in the United States.
If no, please explain.
Have you ever been convicted of a felony or are you on bail pending trial for a felony?
If yes, please explain in full with description of the case.
Skills, abilities, qualifications or experiences which you feel would fit you to work for Elliot Security:
Do you have or anticipate any obligations which could conflict with a standard work schedule or performance of assigned duties.
If yes, describe.

*EDUCATION HISTORY*

Languages Spoken:

High School/GED?
Last High School Attended:
Name City State Grade Completed

Junior College Attended:
Name City State Year Completed
Major			Minor

College or University Attended:
Name City State Year Completed
Major			Minor

Trade School Attended:
Name City State Year Completed
Major			Minor

Professional School:
Any Special Training?

*PROFESSIONAL REFERENCES*
Please list 2 references other than people related to you or past employers:

1. Name
Address		Telephone
Relationship		Years Known

2. Name
Address		Telephone
Relationship		Years Known

In case of emergency, whom should we notify?
Name
Address
City	State			Zip Code
Telephone	Relationship

*EMPLOYMENT HISTORY*

List your present or last position.
Company Name	Address
Phone	Name/Title of Supervisor
Job Title
Starting Pay Ending Pay
Dates of Employment (Month/Year) from to
Type of work performed
Reason for Leaving


List your previous position.
Company Name	Address
Phone	Name/Title of Supervisor
Job Title
Starting Pay Ending Pay
Dates of Employment (Month/Year) from to
Type of work performed
Reason for Leaving


List your previous position.
Company Name	Address
Phone	Name/Title of Supervisor
Job Title	Ending Pay
Starting Pay Ending Pay
Dates of Employment (Month/Year) from to
Type of work performed
Reason for Leaving

May we contact your present employer?
Did you complete this form yourself? If not, who did?

*ARMED SERVICE HISTORY*

Have you ever been granted a security clearance?
Have you ever been in the Armed Forces?
Are you currently a member of the Army Reserves or the National Guard?
If yes, Date Entered Discharge Date
Specialty or MOS
Do you have a current Kentucky Concealed Carry Permit? If yes, Expiration Date

*READ STATEMENTS BELOW CAREFULLY BEFORE AGREEING*
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I further certify that I am 18 years of age or older. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I understand and agree that if hired, my employment is for no definite period and may, regardless of the date of payment of my wages, be terminated at any time without notice. I understand that all applicants are subject to a pre-employment drug screening and criminal background check. Elliott Security Company is a wholly owned company of G2~Blackhawk Inc. and is always looking for qualified and motivated employees to serve as Security Officers. Applicants "MUST" have a clean criminal record pass a criminal background check and drug screen. Applicants "MUST" have high school diploma or GED. Applicants "MUST" have a valid drivers license with reliable transportation and telephone - NO exceptions. A neat haircut above the collar for males, no visible tattoos or facial piercings.
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