Starside

STARSIDE SECURITY & INVESTIGATION, INC.

APPLICATION FORM EMPLOYMENT

1. PERSONAL DATA

Position Desired:
Last name:    First name:    Middle name:
Social Security #:
List your residence addresses for the past five years. Give most recent first, using additional sheets if necessary, (PO Box is not acceptable).
Number and Street City State Zip Code Period
From To
Home Phone:
Work Phone:
Cellular Phone:
Email Address:
To Complete our records, please indicate all other names you have used while working or going to school.

2. EDUCATION

  Name and Location of School Year Finished Did You Graduate Subjects Studies
High School
       
College
       
Trade School
       
Subject of Special Study, Additional Languages, etc.

3. PRIOR GUARD INFORMATION

Guard Card # Exp. Date    
Firearm Card # Exp. Date Caliber:
PR24 Card # Mace Card # CPR
Straight Baton Card # Pepper Spray Card # First Aid

4. REFERENCES

Name Address Business/Company Telephone # Years Known

5. EMPLOYMENT HISTORY

(A RESUME WILL NOT BE ACCEPTED IN LIEU OF COMPLETING THIS SECTION)

List all employment for the past 10 years or since leaving school, starting with your most recent job. All time should be accounted for. If you were unemployed for any period, state your activities during that time.
  Responsibilities Supervisor's
Name & Number
Reason for Leaving
Employer Name:
Employer Address:
City:
State:
Zip:
Position:
Ending Wage:
FT/PT:
Employed From/To:
May we contact your present Employer:
Employer Name:
Employer Address:
City:
State:
Zip:
Position:
Ending Wage:
FT/PT:
Employed From/To:
May we contact your present Employer:
Employer Name:
Employer Address:
City:
State:
Zip:
Position:
Ending Wage:
FT/PT:
Employed From/To:
May we contact your present Employer:
Employer Name:
Employer Address:
City:
State:
Zip:
Position:
Ending Wage:
FT/PT:
Employed From/To:
May we contact your present Employer:

6. MEDICAL HISTORY

Within the last ten years, have you been under a Doctor's or Hospital's care as the result of an injury or illness?

If Yes, Please give the Doctor or Hospital's Name, Dates and Circumstances.

Have you ever filed Bankruptcy ?

If YES, When (Date), Why, explain:

Have you ever taken illegal narcotics ?

If YES, When was the last time you used that narcotic (Date), How often, elaborate:

Have you ever been convicted of a Felony or Misdemeanor * ?
* Including Drunk Driving, Driving Under the Influence (Even if Record was Expunged or Sealed)

If YES, When (Date), Why, explain:

Have you ever had or do still have any of the following ?

Amputations
Back Problems
Broken Bones
Cancer or Tumor
Circulatory Disease
Concusion
Defective Hearing
Defective Sight
Diabetes
Dislocations
Dizziness
Epilepsy
Fainting
Hepatitis
Heart Disease
Hernia or Rupture
High Blood Pressure
Lung Condition
Skull Fracture
Stiff Joints
Strains
Tuberculosis
   
   

If YES to any of the above, explain:

I understand that STARSIDE SECURITY & INVESTIGATION has work available seven (7) days a week and twenty-four hours a day. If employed, I agree to work any Hours, Day(s) or Shift(s) deemed necessary. Initials:

7. AVAILABLE SHIFTS

Shift Sun. Mon. Tues. Wed. Thurs. Fri. Sat.
Day
Swing
Grave

 

AUTHORIZATION

The facts set forth in my application for employment are true and complete. I understand that if employed, any false statement on this application may result in my dismissal. I further understand that this application is not intended to be a contract of employment, nor does this application obligate Starside Security & Investigation, Inc. Hereafter ( Starside) in any way if Starside decides to employ me. You are hereby authorized to make any investigation of my personal, professional and financial history using any public records and credit bureaus you deem necessary.

In making this application for employment I authorize you to make an investigative report whereby information is obtained through personal interviews with my neighbors, friends and others whom I am acquainted. This inquiry may include information as to my character, reputation and lifestyle. I understand I have the right to make a written request within a reasonable period of time to receive additional information regarding the nature of any such report that is made.

I understand that if I am employed byStarside Security & Investigation in a position that requires a uniform that I will adhere to a dress and grooming standard comparable to a uniformed military or police officer. Such grooming standards Include, but are not limited to, a clean appearance, neat haircut, no beard, and a clean, well maintained uniform.

I understand and agree that if employed by Starside Security & Investigation,Inc my employment will be on a AT-WILL basis. Meaning my employment and compensation with Starside Security & Investigation can be terminated, with or without cause, and with or without notice at any time, at the option of either the company or me. I further Understand and agree that if hired that the at-will nature of my employment relationship can not be modified except by a written agreement signed by an Operations Manager of Starside and me.

I understand that a facsimile or reproduction of this form bearing my signature may be sent, faxed or delivered to my present or previous employer(s) or persons I have been acquainted with.

"I authorize any present or former employer(s) or persons I have been acquainted with, to release written or verbal report (s) regarding my conduct, behavior, punctuality, reliability or dependability and I hereby release any company and person (s) divulging such information from liability regarding the release of same."

  09/30/2014
Signature of Applicant   Date