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Victory Security | Apply Here
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Apply Here

Please complete ALL sections of this application. Where choices are provided, check the most appropriate response(s).



PERSONAL INFORMATION

First Name:

Last Name:

Middle Name:

Phone Number:

Email:

Over 18 years of age?
YesNo
U.S. Citizen?
YesNo
Registered Alien?
YesNo


RESIDENCES

List residences for the last five (5) years starting with the most recent.

First Residence

Number and Street:

City (or Town):

State:

Zip Code:

From:

To:



Second Residence

Number and Street:

City (or Town):

State:

Zip Code:

From:

To:



Third Residence

Number and Street:

City (or Town):

State:

Zip Code:

From:

To:



POSITION APPLYING FOR

What position are you applying for?

Full TimePart Time
Have you completed an application with Victory Security Agency previously?
YesNo
Do you object to wearing a uniform?
YesNo
Are you willing to work overtime when needed?
YesNo
Are you willing to work various shifts?
YesNo
Act 235?
YesNo


TRANSPORTATION

PublicOwn Personal VehicleValid PA Driver's License


EDUCATION

List all schools, including any special training schools:

Name of School and Address
(City and State)
Select Last Year Completed Graduate (Yes or No) Course of Study
Elementary 5668 YesNo
High School 9101112 YesNo
College 1234 YesNo
Other 1234 YesNo
Other 1234 YesNo

Are you known to schools/references by another name?
YesNo

If yes, by what name?



MILITARY SERVICE

Branch:

Date Entered:

Date Completed:

Type of Discharge Received:

Reserve/National Guard Status
ActiveInactive


CHARACTER REFERENCES

Give full names of three (3) people who have known you for at least five (5) years. Do not give former employers or relatives.

First Reference

Name:

Street Address:

City, State, Zip:

Phone:



Second Reference

Name:

Street Address:

City, State, Zip:

Phone:



Third Reference

Name:

Street Address:

City, State, Zip:

Phone:



ADDITIONAL QUALIFICATIONS

First Aid CertifiedCPR CertifiedEMT CertifiedWeapon Certified

Are you able to perform the essential functions of the position for which you are applying?
YesNo

If no, explain:

Have you ever been bonded?
YesNo


EMPLOYMENT HISTORY

List all periods of employment for the past ten (10) years, starting with the most recent employer and work backwards. Any periods of unemployment must be noted.

First Employment

Dates (Month and Year)
From:

To:

Employer:

Street Address:

City, State, Zip:

Phone:

Type of Position Held:

Name of Supervisor:

Title of Supervisor:

Rate of Pay:

Reason for Leaving:

Second Employment

Dates (Month and Year)
From:

To:

Employer:

Street Address:

City, State, Zip:

Phone:

Type of Position Held:

Name of Supervisor:

Title of Supervisor:

Rate of Pay:

Reason for Leaving:

Third Employment

Dates (Month and Year)
From:

To:

Employer:

Street Address:

City, State, Zip:

Phone:

Type of Position Held:

Name of Supervisor:

Title of Supervisor:

Rate of Pay:

Reason for Leaving:

Fourth Employment

Dates (Month and Year)
From:

To:

Employer:

Street Address:

City, State, Zip:

Phone:

Type of Position Held:

Name of Supervisor:

Title of Supervisor:

Rate of Pay:

Reason for Leaving:

Are you employed at the present time?
YesNo
May we contact your present employer?
YesNo
Are you on lay-off and subject to recall?
YesNo
Have you ever been dismissed or asked to resign from employment?
YesNo
If yes, reason:

Date:

Employer:

Have you ever been convicted of a crime by a civilian or military court?
YesNo
If yes, list convictions and state circumstances:

State laws prohibit the employment of security officers with certain types of convictions. In addition, state laws require a comprehensive evaluation of persons entering private security. This includes a criminal record search. Employment may be terminated if a criminal record is found.


Please write a paragraph of 50 words or more explaining why you are interested in security. Include your likes and dislikes.

Date of Birth (optional):


The Age Discrimination in Employment Act prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age. You must be 18 years of age to be considered for employment.


HEALTH: Many health-related problems are classified as handicaps. State and Federal laws prohibit discrimination based on the handicap of an otherwise qualified applicant. Upon being offered employment, your medical history will be reviewed. You may be asked to take a physical examination. You will be assigned to only those jobs that you are physically able to perform. Reasonable accommodations will be made. For your information, many state laws prohibit the employment of security officers who have mental or nervous disorders. Also, certain positions, by terms of our contracts, set standards for hearing, vision, speech, walking, lifting and other health related areas. You may choose to discuss areas of concern prior to completion of the employment process.


In consideration of the employment and wages to be paid to me by the Company, I make the following declarations:


I authorize investigation of all matters contained in this application and agree that if, in the judgement of the Company, any misrepresentation has been made by me herein, or if the results of such investigation are not satisfactory, any offer of employment made by the Company may be withdrawn, or my employment with the Company may be terminated immediately without any obligation or liability to me, other than for payment, at the rate agreed upon, for services actually rendered if I have been employed.


I agree that I will not accept employment by any client or former client or competitor of the Company, where I have been employed by the Company, for a period of 120 days from the termination of my employment with the Company. I agree that I will not divulge to anyone, other than as I may be directed by the Company, any information acquired by me during my employment, except as may be required by law.


I understand that all appointments are probationary for 90 days, during which time I must demonstrate my ability for continued employment. I further certify that all statements made by me on this application are true and complete to the best of my knowledge and belief.


HOW DID YOU LEARN ABOUT VICTORY SECURITY AGENCY?
Walk-InAdvertisementFriendEmployment AgencyRelativeInternetYellow PagesEmployee

If you checked Employee:
Name:

Telephone:



Signature of Applicant:




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