Name
*
First Name
Last Name
Email
Phone
*
(###)
###
####
Current Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
If under the age of 18, can you produce the necessary work certificate at the time of employment?
*
Type of employment desired?
*
Are you willing to work overtime?
Date on which you can start work, if hired:
*
MM
DD
YYYY
If hired, can you provide proof that you are legally eligible for employment in the U.S.?
(Pursuant to the Immigration Reform and Control Act of 1986, all applicants (U.S. and non-U.S.) who are offered employment must produce documents establishing their identity and authorization for U.S. work no later than seventy-two (72) business hours after employment begins. All new hires will be required to verify their employment authorization under oath by signing INS Form 1-9 upon commencing employment.)
Have you previously applied for employment with this Company?
*
If yes, when and where did you apply?
Have you ever been employed by this Company?
If Yes, provide dates of employment, location, and reason for separation from employment.
Do you have any commitments to any other employer which could affect your employment with this Company if hired (for example, an employment agreement, a non-competition, or non-solicitation agreement, etc.)?
If yes, please explain and provide a copy:
Graduate/GED
# of Years Completed
College Course of Study or Major
Graduate/GED?
# of Years Completed
Honors Received
Course of Study or Major
# of Years Completed
Honors Received
Course of Study or Major
# of Years Completed
Honors Received
If you answered yes to either of the above two questions, please explain the circumstances of each occasion.
Company Name
Company Phone
(###)
###
####
Start Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Job Title
Duties
Reason for Leaving?
Supervisors Name
May we contact?
If No, why?
Were you ever disciplined? If so, for what?
If you resigned, how much notice did you give? If none, explain.
Company Name
Company Phone
(###)
###
####
Start Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Job Title
Duties
Reason for Leaving?
Supervisors Name
May we contact?
If no, why?
Were you ever disciplined? If so, for what?
If you resigned, how much notices did you give? If none, explain.
Do you carry your OSHA 10 Certification?
Do you carry a TOPS Alarm Systems Installer License?
Do you carry a TOPS Electronic Access Control Device Installer license?
Do you have a valid Driver's License?
Do you have clear criminal background?
Do you have a clear Motor Vehicle Report?
Do you have reliable transportation?
Are you able and willing to provide proof of COVID Vaccination if requested by one of our clients? (Not a condition of employment)
Do you have a valid Aerial Lift, Scissor Lift, Boom Lift, and/or Man Lift training certification? (Check all that apply.)
Do you have your own equipment? (Check all that apply.)
Are you physically able to climb scaffolding?
Are you interested in travel work, and if yes, to what degree?
Briefly describe any special skills, training, or experience you possess relevant to the position for which you are applying:
List any professional or occupational registration, licensure or certification you currently hold which is relevant to the position for which you are applying and/or indicate whether you have ever had any related professional registration, license, or certification suspended, revoked or terminated:
Reference 1: Name, Position, Company, and Work Relationship
Reference 1: Phone # or Email
Reference 2: Name, Position, Company, and Work Relationship
Reference 2: Phone # or Email
APPLICANT CERTIFICATION
I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver's license for the state in which I reside and automobile liability insurance in an amount equal to the minimum required by the state where I reside.
I understand that the Company may now have, or may establish, a drug-free workplace or drug and/or alcohol testing program consistent with applicable federal, state, and local law. If the Company has such a program and I am offered a conditional offer of employment, I understand that if a pre-employment (post-offer) unlawful drug and/or alcohol test is positive, the employment offer may be withdrawn where allowed by law. I agree to work under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law. I also understand that all employees of the location, pursuant to the Company's policy and federal, state, and local law, may be subject to urinalysis or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that alcohol and/or drug testing may be a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company's policies and applicable federal, state, and local law.
If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning or notice, to conduct investigations of Company property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property. I UNDERSTAND THAT I HAVE NO EXPECTATION OF PRIVACY IN COMPANY PROPERTY. THIS COMPANY IS AN AT-WILL EMPLOYER WHERE ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TO TERMINATE EMPLOYMENT AT-WILL. I UNDERSTAND THAT NO COMPANY EMPLOYEE OR REPRESENTATIVE HAS THE AUTHORITY TO ENTER INTO A CONTRACT REGARDING DURATION OF TERMS AND CONDITIONS OF EMPLOYMENT OTHER THAN THE PRESIDENT/CEO OF THE COMPANY AND THEN ONLY BY MEANS OF A WRITTEN CONTRACT SIGNED BY THE PRESIDENT/CEO.
I AUTHORIZE AND CONSENT TO, WITHOUT RESERVATION, ANY PARTY OR AGENCY CONTACTED BY THIS EMPLOYER (INCLUDING ANY AND ALL PRIOR EMPLOYERS OF MINE) TO FURNISH INFORMATION REGARDING MY PREVIOUS EMPLOYMENT HISTORY AND/OR ANY OF THE ABOVE-MENTIONED INFORMATION. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company for seeking such information and all other persons, corporations, or organizations furnishing such information.
If hired by the Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company as required by the Immigration Reform and Control Act of 1986. I also understand this Company employs only individuals who are legally eligible to work in the United States.
CALIFORNIA PUBLIC RECORDS DISCLOSURE
I acknowledge that in connection with my application for employment or subsequent employment, The Company may collect, assemble, evaluate, compile, report, transmit, transfer or communicate information on my character, general reputation, personal characteristics or mode of living which are matters of public record without using a third-party investigative consumer reporting agency. Matters of public record are defined as records documenting an arrest, indictment, conviction, civil judicial action, tax lien, or outstanding judgment.
I understand that such public record information generally must be disclosed to me within seven days of the date the information is received, regardless of whether it is received orally or in writing. I understand that I may waive my right to receive such information.
By checking this box I hereby waive my right to any such disclosure.
FLORIDA APPLICANTS: I understand that, in accordance with Florida Statute § 443.131(3)(a)(2), if hired, I will be placed on a 90-day probationary period. I further understand that if I am terminated for unsatisfactory work performance within the 90-day probationary period, the Company may seek to contest any employment benefit I might attempt to obtain as a result of my termination.
Acknowledgement:
(Applicant Initials)
MM
DD
YYYY
Applicant Signature
First Name
Last Name
MM
DD
YYYY
If the applicant is a minor, the foregoing release and consent must be signed by the applicant's parent or legal guardian. Signature by the applicant's parent or legal guardian constitutes acknowledgement by the applicant and the parent or legal guardian that the Company, to the extent permitted by federal, state, and local law, can test the applicant for illegal or controlled substances, conduct inspections of property without notice, and communicate test results to Company personnel who need to know, the applicant, and the applicant's legal guardian.
Parent/Legal Guardian Signature
First Name
Last Name
MM
DD
YYYY
