American Corporate Security Employment Application

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ACS Employment Application

Key Code: (if applicable)

Your Email Address: (A valid email is required)
A valid email address is required.Not a valid email address

Applicant Name:

A value is required.	A value is required.
First	Last	Middle Init.

Address:

A value is required.
Address

Address line 2
A value is required.	Please select an item.	A value is required.
City	State	Zip

Phone:
A value is required.

Have you ever been convicted of a crime or are you currently charged with or under investigation for any crime?
(This item includes misdemeanors and felonies regardless of the length of time which has lapsed since their occurrence. Minor traffic violations resulting in a fine of $499 or less do not need to be disclosed. Convictions dismissed under Section 1203.4 of the Penal Code MUST be disclosed.)
Please select an item.

If yes, please explain:

How were you referred to ACS? Please check the box in front of the most appropriate selection below:
Employee Referral
Other: Please Explain
College or University
Recruiter or Agency
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If you checked Other, please explain:

Address History
If you have lived at your current address for less than 10 years, please complete this section:

Previous Address 1
From	To
Address (St. Address, City, State, Zip)

Previous Address 2
From	To
Address (St. Address, City, State, Zip)

Previous Address 3
From	To
Address (St. Address, City, State, Zip)

ADA Section
Note: American Corporate Security complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions of his/her job.

Are you able to perform all duties of the job for which you are applying?

Yes No Please specify a value.

All employees who are hired for American Corporate Security may be required to stand a guard post from time to time. Do you have any medical conditions that preclude you from standing, walking, or climbing stairs?

Yes No Please specify a value.

If yes, please explain:

Are you currently employed?

Yes No Please specify a value.

If yes, may we contact your current employer?

Yes No Please specify a value.

Position Applying for?
Please select an item.

Availability:

	Days		Swing		Graveyard
	Full time		Part time

Are you at least 18 years of age?

Yes No Please specify a value.

Have you previously served in the military?

Yes No Please specify a value.

List any special skills or abilities you obtained as a result of your service:

Do you have a valid Driver's license?

Yes No Please specify a value.

If Yes:

State	License #	Expiration

Has your driver's license ever been suspended?

Yes No Please specify a value.

If yes, please state reason(s), date of revocation or suspension, and the date of reinstatement:

Do you currently have a State-Issued Guard License?

Yes No Please specify a value.

If Yes:

State	License #	Expiration

Do you have a current CPR and/or First Aid card?
Please select an item.

CPR Card Expiration Date

First Aid Card Expiration Date

Name of any other Licenses or Certifications

Other License/Certification State

Other License/Certification Expiration Date

Have any of the above listed permits ever been revoked or suspended?

Yes No Please specify a value.

If yes, please state reason(s), date of revocation or suspension, and the date of reinstatement:

Employment History
Starting with your most recent employer, please list below all present and past employment for the past ten (10) years. Make sure to list all periods of unemployment.

Employer Name #1 (current or most recent)
A value is required.

Employer Address
A value is required.
Address

Address line 2
A value is required.	Please select an item.	A value is required.
City	State	Zip

Employer Phone:
A value is required.

Supervisor Name:
A value is required.

Dates of Employment:

A value is required.	A value is required.
From	To

Type of Business:
A value is required.

Your Position:
A value is required.

Your Duties:
A value is required.Minimum number of characters not met.

Hourly Pay Rate:

A value is required./hr.	A value is required./hr.
Starting	Ending

Reason for Leaving:
A value is required.

Employer Name #2

Employer Address

Address

Address line 2

City	State	Zip

Employer Phone:

Supervisor Name:

Dates of Employment:


From	To

Type of Business:

Your Position:

Your Duties:

Hourly Pay Rate:

/hr.	/hr.
Starting	Ending

Reason for Leaving:

Employer Name #3

Employer Address

Address

Address line 2

City	State	Zip

Employer Phone:

Supervisor Name:

Dates of Employment:


From	To

Type of Business:

Your Position:

Your Duties:

Hourly Pay Rate:

/hr.	/hr.
Starting	Ending

Reason for Leaving:

Personal References:
List three (3) Personal References who are not related to you.
Note: Personal references can be friends, supervisors, or co-workers, but cannot be a relative.

Reference #1 Name:
A value is required.

Reference Address
A value is required.
Address

Address line 2
A value is required.	Please select an item.	A value is required.
City	State	Zip

Phone:
A value is required.

Number of Years Known:
A value is required.

Relationship:
A value is required.

Reference #2 Name:
A value is required.

Reference Address
A value is required.
Address

Address line 2
A value is required.	Please select an item.	A value is required.
City	State	Zip

Phone:
A value is required.

Number of Years Known:
A value is required.

Relationship:
A value is required.

Reference #3 Name:
A value is required.

Reference Address
A value is required.
Address

Address line 2
A value is required.	Please select an item.	A value is required.
City	State	Zip

Phone:
A value is required.

Number of Years Known:
A value is required.

Relationship:
A value is required.

Education

Name of High School:
A value is required.

City / State of School:
A value is required.

Degree? Or number of years completed?
A value is required.

Name of College:

City / State of College:

Degree? Or number of years completed?

List any certificates earned or in progress, and/or any additional training programs not included in your formal education:

ACS office where you would like to apply:
Please select an item.

This is required.I agree to the terms and conditions of this employment application.



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