step 1 Application for Employment Full Name Address: Home Phone# Cellular Phone# Email Address Next step 2 References (Personal or Professional and NOT related to you) 1 Name (First And Last) Phone# Relationship 2 Name (First And Last) Phone# Relationship 3 Name (First And Last) Phone# Relationship Back Next step 3 Work Availability (Complete section below based on your current day/hours of availability) Sunday 1st Shift (Day)2nd Shift (Evening)3rd Shift (Night)Any Shift Can Only Work From To Monday 1st Shift (Day)2nd Shift (Evening)3rd Shift (Night)Any Shift Can Only Work From To Tuesday 1st Shift (Day)2nd Shift (Evening)3rd Shift (Night)Any Shift Can Only Work From To Wednesday 1st Shift (Day)2nd Shift (Evening)3rd Shift (Night)Any Shift Can Only Work From To Thursday 1st Shift (Day)2nd Shift (Evening)3rd Shift (Night)Any Shift Can Only Work From To Friday 1st Shift (Day)2nd Shift (Evening)3rd Shift (Night)Any Shift Can Only Work From To Saturday 1st Shift (Day)2nd Shift (Evening)3rd Shift (Night)Any Shift Can Only Work From To How many hours per week are your looking to work FTPT Do you have reliable transportation? YESNO Some locations may require you to use your personal vechicle for duty. Will this be a problem? YESNO Are you available to work HOLIDAYS/OVERTIME? YESNO Available to start working on date? If hire, how would you like to be paid? Direct DepositCheck *Payday is weekly Have you ever served in U.S. Millitary YESNO If yes are you currently active or in the reserves? YESNO Do you have or can you obtain the following to wear with our uniform? YESNO Black Work Shoes (No sneakers), Black Dress Pants, Black Belt, Black T-Shirt and Black Socks Have you ever been fired or laid off from work? YESNO If yes, please explain below. Have you ever been convicted of a Felony or Misdmeanor? YESNO If yes, please explain below. Explain why you want to work for Harrisburg Security, Inc. and how you can help the company if you are hired. Back Next step 4 Employment History Start with your most recent or current job. Harrisburg Security, Inc. is committed to providing equal opportiunity employment to employees without regard to race, religion, creed, age, gender, any disability unrelated to an individual's ability to perform adequately or and other characteristic protected by law. 1 Employer Name Address Phone# Dates Employed From To Hourly Rate Salary From To Reason for Leaving Job Title Supervisor Duties Performed May we contact this employer? YESNO Shift(s) worked (Check all that apply) DAYEVENINGNIGHT 2 Employer Name Address Phone# Dates Employed From To Hourly Rate Salary From To Reason for Leaving Job Title Supervisor Duties Performed May we contact this employer? YESNO Shift(s) worked (Check all that apply) DAYEVENINGNIGHT 3 Employer Name Address Phone# Dates Employed From To Hourly Rate Salary From To Reason for Leaving Job Title Supervisor Duties Performed May we contact this employer? YESNO Shift(s) worked (Check all that apply) DAYEVENINGNIGHT 4 Employer Name Address Phone# Dates Employed From To Hourly Rate Salary Reason for Leaving Job Title Supervisor Duties Performed May we contact this employer? YESNO Shift(s) worked (Check all that apply) DAYEVENINGNIGHT Back Next step 5 Education School Name And Address Course of Study Years Attended Did you Graduate? YESNO YESNO YESNO YESNO Please list any specialized training, Skills, internships, certifications, etc... I certify that all information I've listed in this Job Application is accurate to the best of my knowledge Back Next step 6 Equal Employment Opportunity Form Applicant Information Full Name Address: Home Phone: Social Security Number: Position Applied for: Voluntary Information This information is being requested in accordance with federal regulations. The information is voluntary and will not be used when considering you for employment with our company. Racial or Ethnic Group American Indian/AlaskanAsian/Pacific IslanderBlack/African AmericanHispanic/LatinoWhite/CaucasianOther Gender MaleFemale Military Service Pre-Vietnam EraVietnam EraPost-Vietnam EraDisabled Veteran How did you hear about this position? NewspaperCompany EmployeeProfessional PublicationJob FairPlacement OfficeWebsiteOther Back
