employee application

Please provide the following information:

First Name
Last Name
MI
Alias / Maiden Name
Address
Suite/Apt
City State
County Zip
 
Sex Male   Female
Hair Eyes
Weight Height
 
DOB Age
POB S.S.#
Drivers Lic. # Citizenship
Guard Certification # Exp. Date
Telephone Beeper
Cell Email
Questions:
Are you a citizen of the United States or a legal resident of the United States in possession of a valid alien registration card?
Yes  No If you selected No, explain:
Have you ever been convicted in this State or elsewhere of any criminal offense (other than a minor traffic offense)?
Yes   No If Yes, submit an explanation giving the place, court jurisdiction, nature of the offense, sentence and/or other disposition.
Has any license or permit issued to you in New York State or elsewhere ever been revoked or suspended?
Yes   No If YES, please explain.
Have you ever been discharged from a correctional or law enforcement agency for incompetence or misconduct as determined by a court of competent jurisdiction?
Yes   No If YES, please explain.
Have you ever been declared incompetent by reason of mental disease or
defect by any court of competent jurisdiction?
Yes   No If YES, include explanation.
Are you now employed as a POLICE OFFICER or PEACE OFFICER in New York State?
Yes   No If YES, state employer name and address.
Have you ever applied for a license as a Security Guard, Watch Guard or Patrol, or Private Investigator in this state or elsewhere?
Yes   No If YES, please explain.
Have you ever resigned from employment rather than face administrative action or termination?
Yes   No If YES, please explain.
If you are not registered to vote at your current address, you may receive a registration form. You may receive government services without being
registered to vote. Would you like a registration form?
Yes   No  
Employment History (5 years)
You must provide complete information covering this five-year period. No gaps in time during the past five years are permitted. If you were not employed for a period of time, you must list the time period in question and explain why you were not employed -- example: school, medical leave, unemployed, etc
Company Name
Company Address
Company Telephone
Supervisor
Position Status
Employment Dates
From:(mm/yyyy) To:(mm/yyyy)
 
Company Name
Company Address
Company Telephone
Supervisor
Position Status
Employment Dates
From::(mm/yyyy) To::(mm/yyyy)
 
Company Name
Company Address
Company Telephone
Supervisor
Position Status
Employment Dates
From:(mm/yyyy) To:(mm/yyyy)
 
Company Name
Company Address
Company Telephone
Supervisor
Position Status
Employment Dates
From:(mm/yyyy) To:(mm/yyyy)
 
Company Name
Company Address
Company Telephone
Supervisor
Position Status
Employment Dates
From:(mm/yyyy) To:(mm/yyyy)
Please make sure you have answered all questions thoroughly.