APPLICATION FOR EMPLOYMENT
WE ARE AN EQUAL OPPORTUNITY EMPLOYER
ALL EMPLOYEES WILL BE CONSIDERED FOR EMPLOYMENT WITHOUT REGARD TO RACE, RELIGION,
COLOR, SEX, AGE, ANCESTRY, NATIONAL ORIGIN, MARITAL STATUS, VETERAN STATUS, MEDICAL
CONDITIONS, HANDICAP, PHYSICAL OR MENTAL DISABILITY, SEXUAL ORIENTATION OR ANY OTHER
STATUS PROTECTED BY LAW.
PERSONAL How did you hear about Proactive Security Services:
___________________________________________________________________________________________
___________________________________________________________________________________________ ____________________________________________________
Name (Last, First, Middle)
_____________________________ Date
________________________________________________ ‐ __________________________________________
Street Address
City, State, Zip
_________________________________________ __________________________________________
Home Number
Mobile Number
Do you have a valid driver’s license? [ ] Yes [ ] No License # __________________________ State ________
Position applied for:
Office Applied For:
___________________________________________________________________________________________
Do you hold a State Reg. Guard Card? [ ] Yes [ ] No
Permit Number: _________________________
Do you hold a State Firearms Permit?
Permit Number: _________________________
[ ] Yes [ ] No
Have you ever had a security clearance? [ ] Yes [ ] No
What Level: _____________________________
Type of employment desired [ ] Full‐Time [ ] Part‐Time Overtime? [ ] Yes [ ] No
Shift Availability: Morning [ ] Yes [ ] No Swing [ ] Yes [ ] No Grave [ ] Yes [ ] No
Are you under the age of 18? [ ] Yes [ ] No
Do you have the legal right to live and work in the United States? [ ] Yes [ ] No
Will you be able to perform safely and efficiently all functions of the job(s) for which you are assigned?
[ ] Yes [ ] No If no, please explain: ___________________________________________________________________________________________ ___________________________________________________________________________________________
Employees for certain positions will be required to undergo a physical examination including drug, and alcohol testing to ensure that they can safely and effectively perform the job for which they are assigned. Will you take a physical examination or testing if required for pre‐employment screening? [ ] Yes [ ] No
Will you comply with the safety, work, attendance and employment policies of our organization?
[ ] Yes [ ] No
Have you ever been convicted of a felony? [ ] Yes [ ] No
Are you a veteran? [ ] Yes [ ] No
Branch of service: _______________________________ Type of Discharge: _____________________________
______________________________________For Office Use Only_____________________________________
Transportation: __________________ Pay Rate: _______________ Authorized By: ____________________
Armed Guard: Yes __________ No __________
Club Guard: Yes __________ No __________
EDUCATION
School
Name & Location of School
Course of
Study
Years
Completed
Did you
Graduate?
Degree or
Diploma
Graduate School
College
Trade School High School Other
EMPLOYMENT HISTORY______________________________________________________________________
Company Name: __________________________________ Date of Employment: ________________________
Address: