Apply for the job The application form contains 5 pages. Please answer every question in every page completely. Required questions will be marked with an asterisk.National Capital Security, LLC. is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.All your information from this form will be kept private and will be used only for purposes that are clearly identified. Page 1 of 5 Personal Information * First Name Middle Name * Last Name Preferred First Name (if different than your first name) Date of Birth * Year 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 * Month 01 02 03 04 05 06 07 08 09 10 11 12 * Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Contact Information * Email * Home phone * Cell Phone * City * Street Address * State Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * Zip Application Information * Select a job Select... Security Officer Fire Watch Salary Desired Type of Work Desired Full-Time Part-Time Flaxible/On call * List the date you will be available to start work ... next Page 2 of 5 Educational Information High Scool * School Name * City * State Select... Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Graduated Yes No College Bus. or Trade school * School Name * City * State Select... Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Graduated Yes No * Major or Degree Professional School * School Name * City * State Select... Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Graduated Yes No * Major or Degree Other * School Name * City * State Select... Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Graduated Yes No Major or Degree back next Page 3 of 5 Skills Describe Your Skills (1000 chars left) Computer PC Mac Typing Select... Excellent Very good Good Satisfactory Poor Never Typed Criminal Convictions Have you ever been convicted of a crime Yes No If yes, please explain Driver License * Do you have a drivers license? Yes No * State of Issue Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * Driver Licence ID Car Accidents Have you had any accidents in the past 3 years? Yes No How many? Violations Have you had any moving violations in the past 3 years? Yes No How many? back next Page 4 of 5 Most Recent Employer Current Employer? Yes No Name of Employer Name of last supervisor Dates of employment From ... To ... Salary From To Employer Address City State Select... Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Street Adress Phone Last job title Reason for Leaving (be specific) List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company (1000 chars left) May we contact your employer Yes No Employer 2 Name of Employer Name of last supervisor Dates of employment From ... To ... Salary From To Employer Address City State Select... Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Street Adress Phone Last job title Reason for Leaving (be specific) List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company (1000 chars left) May we contact your employer Yes No Employer 3 Name of Employer Name of last supervisor Dates of employment From ... To ... Salary From To Employer Address City State Select... Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Street Adress Phone Last job title Reason for Leaving (be specific) List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company (1000 chars left) May we contact your employer Yes No Reference 1 Name Position Company Phone May we contact Yes No Reference 2 Name Position Company Phone May we contact Yes No back next Page 5 of 5 Upload resume In this section you can upload your resume in DOC, PDF or archive formats (ZIP, RAR). Please choose your file Applicant signature Please read and type your initials for each paragraph to indicate that you have read and agree to the statementsI certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company. * Type initial to certify the above statement is correct I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company. * Type initial to certify the above statement is correct I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation. * Type initial to certify the above statement is correct Sign and date the bottom fields * Applicant's Digital Signature (Please type your full name) * Date ... I'm not a robot Please enter the characters displayed in the image back submit Thank you for filling out the application form! You will receive notification email on your mailbox. Please turn on javascript to submit your data. Thank you!
