Old Dominion Security Company DCJS License 11-3591 PPS 5026P7
PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS PLEASE COMPLETE PAGES 1-5.
DATE ___________________________
NAME________________________________________________________________________ Last
First
MI
Maiden
Present Address _________________________________________________________________ Number
Street
City
State
Zip
How long have you lived there? __________ Telephone (___)___________________
Alternate number (____)____________________
If under 18, please list age _________ Position applying for ___________________ Salary Desired______________________
Days/hours available to work NO PREFERENCE MON _______ THUR ______ TUES ______ FRI _________ WED _______ SAT ________ SUN _________
How many hours are you available to work weekly? _____________ Can you work nights? YES NO Employment Desired
FULL-TIME
PART-TIME
NO PREFERENCE
When will you be available to begin working? __________________________________________________
Type of School
Name of School
Location (Complete Mailing Address)
Number of Years Completed
Major and/or Degree
High School College Bus/Trade School Professional School
HAVE YOU EVER BEEN CONVICTED OF A CRIME? NO YES If yes, explain the number of conviction(s), nature of offense(s) leading to conviction(s), how recent were offense(s) committed, sentence(s) imposed, and types of rehabilitation. _____________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________
PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT DO YOU HAVE A DRIVER’S LICENSE? YES NO What is your primary means of transportation? ________________________________________________ Driver’s license number ___________________ State of issue __________ operator
Expiration date ___________________
commercial
chauffeur
Have you had any accidents during the past 3 years?
YES
NO
How many? ____
Have you had any moving violations in the past 3 years?
YES
NO
How many? ____
OFFICE USE ONLY DCJS Licensed
YES
NO
Expiration __________________________
Personal Computer
YES
NO
PC
MAC
Other Skills ____________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Please list two references other than relatives or previous employers: Name _______________________________ Position _____________________________ Company ____________________________ Address _____________________________ ____________________________________ Telephone (____)______________________
Name ________________________________ Position ______________________________ Company _____________________________ Address ______________________________ _____________________________________ Telephone (____)_______________________
An application for sometimes makes it difficult for an individual to adequately summarize a complete background. Please use the space below to summarize any additional information necessary to describe your full qualifications for the specific position you are applying for: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________
PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT MILITARY HAVE YOU EVER BEEN IN THE ARMED FORCES? ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?
YES
NO YES
NO
Specialty __________________________ Date Entered ______________ Discharge Date___________
Work Experience
Please list your work experience for the past five years, beginning with your most recent job held. If you were self-employed, give firm’s name. Attach additional sheets if necessary.
Name of employer ________________________________ Address ________________________________________ City, State, Zip ___________________________________ Phone number (____)_____________________
Name of last supervisor_________________ Employment dates: from _______to ______ Pay/Salary: start _________final_________ Last job title: _________________________
Reason for leaving-be specific: _____________________________________________________________ List the jobs held, duties performed, skills used or learned, advancements or promotions while you worked at this company: ________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________
Name of employer ________________________________ Address ________________________________________ City, State, Zip ___________________________________ Phone number (____)_____________________
Name of last supervisor_________________ Employment dates: from _______to ______ Pay/Salary: start _________final_________ Last job title: _________________________
Reason for leaving-be specific: _____________________________________________________________ List the jobs held, duties performed, skills used or learned, advancements or promotions while you worked at this company: ________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________
PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT Work Experience
Please list you work experience for the past five years, beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.
Name of employer ________________________________ Address ________________________________________ City, State, Zip ___________________________________ Phone number (____)_____________________
Name of last supervisor_________________ Employment dates: from _______to ______ Pay/Salary: start _________final_________ Last job title: _________________________
Reason for leaving-be specific: _____________________________________________________________ List the jobs held, duties performed, skills used or learned, advancements or promotions while you worked at this company: ________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________
Name of employer ________________________________ Address ________________________________________ City, State, Zip ___________________________________ Phone number (____)_____________________
Name of last supervisor_________________ Employment dates: from _______to ______ Pay/Salary: start _________final_________ Last job title: _________________________
Reason for leaving-be specific: _____________________________________________________________ List the jobs held, duties performed, skills used or learned, advancements or promotions while you worked at this company: ________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________
May we contact your present employer?
YES
NO
Did you complete this application yourself?
YES
NO
If not, who did? _________________________________________________________________________