Employment Application Please complete the entire application Employer Information Employer Advance On-Site Protection Security Address 3636 Menaul Blvd NW Building C Suite 321 City, State Zip Albuquerque, NM 87110 Telephone (505) 897-1307 It is the policy of Advance On-Site Protection Security to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status. Applicant Information Applicant Full Name Home Address City, State Zip Number of years at this address Daytime phone Evening Phone Mobile Phone Social Security Number Drivers License Number Date of Birth Emergency Contact Who should be contacted if you are involved in an emergency? Contact Name Relationship To You Address City, State Zip Daytime Phone Evening Phone Position Information Position Applied For Salary Desired Who Referred You? Do you have friends or relatives who work here? If yes list here: Have you applied to our company previously? If yes, when? Are you at least 18 years old? YesNo How will you get to work? Are you willing to work any shift, including nights and weekends YesNo If no, please state any limitations: If applicable, are you available to work overtime? YesNo If you are offered employment, when would you be available to begin work? If hired, are you able to submit proof that you are legally eligible for employment in the United States? YesNo Are you able to perform the essential functions of the job position you seek with or without reasonable accommodation? YesNo What reasonable accommodation, if any, would you request? Applicant's Skills List any other skills that may be useful for the job you are seeking. Enter the number of years of experience and circle the number which corresponds to your ability for each skill. (One represents poor ability, while five represents exceptional ability.) Typing Microsoft Office Suite (Word, Excel, etc.) Customer service Security Background Applicant Employment History List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment. Employer 1 Employer Name Supervisor Name Address City, State Zip Job Duties Employer Name Dates of Employment (Month/Year): Employer 2 Employer Name Supervisor Name Address City, State Zip Job Duties Employer Name Dates of Employment (Month/Year): Employer 3 Employer Name Supervisor Name Address City, State Zip Job Duties Employer Name Dates of Employment (Month/Year): Applicant's Education and Training College/University Name and Address Did you receive a degree? YesNo High School/GED Name and Address Did you receive a degree? YesNo Other Training (graduate, technical, vocational): Please indicate any current professional licenses or certifications that you hold: Awards, Honors, Special Achievements: Did you serve in the military YesNo References List any two non-relatives who would be willing to provide a reference for you. Name Address City/State/ZIP Telephone: Relationship Name Address City/State/ZIP Telephone: Relationship Other Information Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current employer: CERTIFICATION I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination. I authorize Advance On-Site Protection Security to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education. If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Owner, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Advance On-Site Protection Security, except in a specific written contract of employment signed on behalf of the organization by its Owner, has the power to alter or vary the voluntary nature of the employment relationship. I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.