Application For Employment

    Personal Information

    Name

    Present Address

    Permanent Address



    Employment Desired

    Type of Employment Desired: Full Time  Part Time  Temporary  Internship

    Are you currently employed?

    YESNO

    If so, may we inquire of your present employer?

    YESNO

    If YES, provide work # and best time to call:

    Have you ever filed an application here before?

    YESNO  

    Have you ever worked for Willo Security before?

    YESNO  

    Proof of work eligibility will be required upon employment. Are you authorized to work in the U.S.?

    YESNO

    Have you ever been convicted of a felony?

    YESNO  

    Will you work nights, weekends, and overtime if required?

    YESNO

    Can you perform the essential functions of the job for which you are applying with or without accommodation?

    YESNO


    Education

    List last three (3) schools attended, starting with the most recent.




    General

    U.S Military Or Naval Service?

    YESNO 

    Are you currently enrolled in the National Guard or Reserves?

    YESNO

    In Case Of Emergency Notify


    Former Employers

    List your last four (4) employers, assignments, or volunteer activites, starting with the most recent.

    Starting Hourly Rate/Salary:

    $ per

    Final Hourly Rate/Salary:

    $ per

    May We Contact for Reference?

    YESNOLATER


    Starting Hourly Rate/Salary:

    $ per

    Final Hourly Rate/Salary:

    $ per

    May We Contact for Reference?

    YESNOLATER


    Starting Hourly Rate/Salary:

    $ per

    Final Hourly Rate/Salary:

    $ per

    May We Contact for Reference?

    YESNOLATER


    Starting Hourly Rate/Salary:

    $ per

    Final Hourly Rate/Salary:

    $ per

    May We Contact for Reference?

    YESNOLATER


    Language Skills

    List any foreign language(s) and check the box that best describes your proficiency level.

    Read: FULLMODERATEBASIC

    Write: FULLMODERATEBASIC

    Speak: FULLMODERATEBASIC


    Read: FULLMODERATEBASIC

    Write: FULLMODERATEBASIC

    Speak: FULLMODERATEBASIC


    Read: FULLMODERATEBASIC

    Write: FULLMODERATEBASIC

    Speak: FULLMODERATEBASIC


    Skills and Qualifications

    Summarize special skills and qualifications acquired from employment, or other experiences that may qualify you for work with our organization.


    References

    (Below, please list three people not related to you, whom you have known at least one year)




    Professional, Trade, Business or Civic Associations and Any Offices Held

    Exclude memberships that would reveal sex, race, religion, national origin, age ancestry, disability, or other protected status.


    Certifications, Special Accomplishments and/or Awards


    Additional Information

    List any additional information you would like us to consider.


    Disclaimer and Signature

    I certify that I have read and understood all of this employment application.
    I give the Employer the right to investigate all references and confirm the accuracy of the information I have provided herein. I hereby release from any and all liability the Employer and its representatives for seeking such information and all other former employers, schools, persons, corporations, organizations and other reference sources for furnishing such information.

    I understand that if I am extended an offer of employment, I may be required to a submit to a complete physical examination, including blood and/or urine drug testing, to determine my ability to perform the essential functions of the job, and that any offer is conditioned upon the results of the examination. I authorize the examining health care provider to disclose to the Employer the results of such examination.

    I hereby certify that the above information is true and complete and agree that any false information, misrepresentations, or material omissions in the application and interview process, including any given at the time of my post-offer pre-employment physical may be cause for rejection or may be cause for subsequent dismissal if I am hired.

    Furthermore, I understand that if employed, just as I will be free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary.

    The Employer is an equal opportunity employer. The Employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excluding any applicant’s consideration for employment on a basis prohibited by local, state or federal law.

    This application is current for only ninety (90) days. At the conclusion of this time, if I have not heard from the Employer and still want to be considered for employment, it will be necessary for me to fill out a new application.