Job Application

Job You Are Applying For *

PERSONAL INFORMATION

Name *

First

Middle

Last

Email *

Home/Cell Phone *

Business Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date You Can Start Work

Desired Compensation

Do you have a High School Diploma or GED?

Yes
No

POSITION INFORMATION

Check all you are willing to work.

Hours *

Full Time
Part Time

Times *

Days
Evenings

Shifts *

Swing
Graveyard
Weekends

Status *

Regular
Temporary

Are you authorized to work in the U.S. on an unrestricted basis? *

Yes
No

Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment.) *

Yes
No

If "Yes", explain:

Have you been told the essential functions of the job or have you been viewed a copy of the job description listing the essential functions of the job? *

Yes
No

Can you perform these essential functions of the job with or without reasonable accommodation? *

Yes
No

QUALIFICATIONS

Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, and military training.

School #1 (Name)

Degree

Address/City/State

School #2 (Name)

Degree (School #2)

Address/City/State (School #2)

School #2 (Name)

Degree (School #3)

Address/City/State (School #3)

SPECIAL SKILLS

List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.

List Special Skills

REFERENCES

Please list three professional references not related to you, with full name, address, phone number, and relationship. If you don’t have three professional references, then list personal, unrelated references.

REFERENCE #1

Name

First

Last

Phone

Relationship to Reference

REFERENCE #2

Name

First

Last

Phone

Relationship to Reference

REFERENCE #3

Name

First

Last

Phone

Relationship to Reference

WORK HISTORY

Start with your present or most recent employment and work back. Use separate sheet if necessary. (INCLUDE PAID AND UNPAID POSITIONS)

JOB #1

Job Title

Start Date

End Date

Company Name

Supervisor's Name

Phone Number

City/State

Duties

Reason For Leaving

Starting Compensation

Ending Compensation

May we contact your current employer?

Yes
No
N/A

JOB #2

Job Title

Start Date

End Date

Company Name

Supervisor's Name

Phone Number

City/State

Duties

Reason For Leaving

Starting Compensation

Ending Compensation

JOB #3

Job Title

Start Date

End Date

Company Name

Supervisor's Name

Phone Number

City/State

Duties

Reason For Leaving

Starting Compensation

Ending Compensation

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application. I acknowledge and understand that the company is an “at will” employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.

By checking this box, I agree with the above statement. *

I Agree

Upload Your Resume

Click or drag a file to this area to upload.

If you would like to upload your resume, we accept the following file formats: .pdf, .doc, .jpg, .png.

ONLINE JOB APPLICATION

PERSONAL INFORMATION

POSITION INFORMATION

QUALIFICATIONS

SPECIAL SKILLS

REFERENCES

REFERENCE #1

REFERENCE #2

REFERENCE #3

WORK HISTORY

JOB #1

JOB #2

JOB #3

Contact Caruth Protection Services • (214) 919 – 2231

Caruth Protection Services

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