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QPS APPLICATION FOR EMPLOYMENT

Date

Name

First Last

Phone

Social security (no dashes)

Address

City, State, and Zip Code

Date of Birth

Drivers License Number

Email

Position Applying For

Referred by

Date You Can Start

Are You Emploed? If Yes, may we contact your Current Empoyer*

Yes
No

Type of Employment Desired

Full Time
Part Time

Salary Desired*

Have You ever applied here before?

Yes
No

Where and When?

Years in Security

Are you legally eligible for employment in this country?

Yes
No

Are you able to work Day and/or Night shifts? If NO, please explain

Are you willing to work Holidays, Weekends, and/or Overtime?

Are you able to meet attendance requirements for this position?

Are you 18+ or older and do you have a work permit?

Will you travel if job requires?

EMPLOYMENT HISTORY:

Provided the following information of your past and current employers, assignments or volunteer activities, starting with the most recent (use additional sheets if necessary).

Employer Name, Address & Phone Number

Position Title

Starting Date

End Date

Immediate Supervisor Name

May we contact for reference?

Yes
No

Reason for leaving?

Employer Name, Address & Phone Number

Position Title

Starting Date

End Date

Immediate Supervisor Name

May we contact for reference?

Yes
No

Reason for leaving?

EDUCATIONAL BACKGROUND

List last school attended, starting with most recent. Turn a copy of each certification in along with application.

High School, Vocational School, College

Skills

Summarize any special training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.

List all Military experience, and also include DD214 with your application.

FOR OFFICE USE ONLY

Full/Part Time, Any Shift, Reliable Trans, Experience

Interviewed by

Orientated by

APPLICANT STATEMENT:

I certify that all information I have provided in order to apply for and secure work with QPS is true, complete and correct.

I understand that any information provided by me that is found to false, incomplete or misrepresented in any respect, will be sufficient cause to (1) cancel further consideration of this application, or (2) immediately discharge me from the employer’s service, whenever it is discovered.

I authorize, without reservation, the employer, its representatives, or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I herby waive any and all rights and claims I may have regarding the employer, its agents, employee or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations, or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application in used for the purpose of limiting or excusing local, state or federal law.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice. The employer also reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the US and that the Federal Immigration Laws require me to complete an I-95 Form in the regard.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Sign and Date