Guard Application form Download Printable Version

All information contained in this document will remain strictly confidential



How did you hear about us?:
Date:
Position Applied for:
Last Name:
First Name:
MI:
Home Address:
City:
State:
Zip:
Country:
Phone:
Email:
SS#:
Shirt Size:
Trouser Size:
Blazer Size:
Shoes Size:

Background questions

Answer all questions by checking yes or no: YES NO
1. Are you at least 18 years old?
2. Are you a citizen of the United States or a Resident alien in possession of a valid alien registration card or legally to work in the state you are applying for:
3. Have you ever applied in this state for a registration/License as a Guard.
4.
If yes,please provide the license number:
5. Do you have any security guard experiences?
If yes, what was your position,
the name of the company and phone number?
6. Are you an active or retired peace officer?
7. Are you a veteran?
8. Are you an active police or retired police officer?
9. Are you available to work any shift including weekend?
10. Have you ever discharged from a correctional or law enforcement agency for incompetence or misconduct as determined by a court of competent jurisdiction, administrative rearing officer, administrative law judge, arbitration panel or other duly constituted tribunal, resigned from such an agency while charged with misconduct or incompetence?
If yes, please submit an explanation:

Criminal history

11. Do you have any pending criminal charges or a prior conviction?
If yes, please submit an explanation and provide copies of any records received from the criminal court.

References

12.
Full Name:
Contact info:
13.
Full Name:
Contact info:
14.
Full Name:
Contact info:

Applicant certification

I certify that the information provided on the 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 Back To Back Security Services, Inc. to contact my former employers and my references. I authorize those persons designated to fully and freely communicate information regarding my previous employment.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.
APPLICANT:
DATE:

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