Eagle Protection Job Application

Employment

Name and Contact Information
First Name (*)	Please enter your first name.
Middle Initial	Invalid Input
Last Name (*)	Please enter your last name.
Street Address (No PO Boxes Allowed)	Invalid Input
City	Invalid Input
State	Invalid Input
Zip Code	Invalid Input (xxxxx-xxxx)
Home Phone	Invalid Input (xxx-xxx-xxxx)
Other Phone	Invalid Input (xxx-xxx-xxxx)
Email Address (*)	Please enter your email address.
Position Information
Have you ever applied for work with Eagle Protection Services before?	YesNoInvalid Input
Position you are applying for: (Hold down the Ctrl button to make multiple selections)	Invalid Input
Are you seeking full or part time work? (Hold down the Ctrl button to make multiple selections)	Full Time Part Time Invalid Input
What days are you available to work? (Hold down the Ctrl button to make multiple selections)	Invalid Input
What times are you willing to work? (Hold down the Ctrl button to make multiple selections)	Invalid Input
If employed and you are under 18 can you furnish a work permit?	YesNoN/AInvalid Input
Do you have a valid drivers license?	YesNoInvalid Input
Do you have reliable transportation?	YesNoInvalid Input
Are you willing to travel up to 40 miles one way from your home to a job site?	YesNoInvalid Input
What is your level of formal education?	Invalid Input
What languages do you speak? (Hold down the Ctrl button to make multiple selections)	Invalid Input
Guard/Military Experience
Have you served in the US military?	YesNoInvalid Input
If yes, please select which branch:	Invalid Input
If you served in a foreign military, enter country/branch:	Invalid Input
Current status:	Invalid Input
License Information
Please indicate the Security Guard licenses you possess. Check all that apply.	VA Unarmed VA Armed MD Unarmed MD Armed DC SO DC SPO Armed DC SPO Unarmed Invalid Input
Legal Information
Have you ever been convicted of a misdemeanor or felony?	YesNoInvalid Input
If you answered yes to being convicted of a misdemeanor or felony please explain:	Invalid Input
The nature of security work is demanding physically and mentally. It requires walking for long periods of time, running, bike riding, lifting, pushing, pulling & bending. It also requires mental acuity in judgment, observation and memory, vision to see near & far and hearing others speak. Do you have any limitations that will prevent you from performing your duties & responsibilities in an emergency situation that may involve some or all of the physical and mental demands above?	YesNoInvalid Input
If yes, please explain your limitations :	Invalid Input
Eagle Protection Services maintains a crime and drug free work environment. To apply for a employment you acknowledge your willingness to submit to a criminal background check and an initial drug test and if employed to fingerprinting and random drug testing as a requirement for employment.	I agreeI do not agreeInvalid Input
For purposes of compliance with The Immigration Reform and Control Act, are you legally eligible for employment in the United States? Under the Immigration Reform and Control Act of 1986, you will be required to fill out a certification verifying that you are eligible to be employed and verifying your identity. Further, you will be required to provide documentation to that effect should you be employed.	YesNoInvalid Input
Employment History
May we contact your current employer?	YesNoInvalid Input
Are there any employers you do not want us to contact? (Please list in the box to the right the names of any employers that we do no have your permission to contact.)	Invalid Input
Current or Most Recent Employer Name:	Invalid Input
City, State, Zip	Invalid Input
Employer's Phone No.:	Invalid Input
Immediate Supervisor's Full Name:	Invalid Input
Start Date:	Invalid Input (mm/dd/yy)
End Date: (if currently employed leave blank)	Invalid Input (mm/dd/yy)
Current Salary: (hourly)	Invalid Input (00.00)
Your Job Duties & Responsibilities:	Invalid Input
Reason for leaving:	Invalid Input
Previous Employer 2 Name:	Invalid Input
City, State, Zip	Invalid Input
Employer's Phone No.:	Invalid Input
Immediate Supervisor's Full Name:	Invalid Input
Start Date:	Invalid Input (mm/dd/yy)
End Date:	Invalid Input (mm/dd/yy)
Ending Salary: (hourly)	Invalid Input (00.00)
Your Job Duties & Responsibilities:	Invalid Input
Reason for leaving:	Invalid Input
Previous Employer 3 Name:	Invalid Input
City, State, Zip	Invalid Input
Employer's Phone No.:	Invalid Input
Immediate Supervisor's Full Name:	Invalid Input
Start Date:	Invalid Input (mm/dd/yy)
End Date:	Invalid Input (mm/dd/yy)
Ending Salary: (hourly)	Invalid Input (00.00)
Your Job Duties & Responsibilities:	Invalid Input
Reason for leaving:	Invalid Input
Personal References
Reference 1 Full Name:	Invalid Input
Phone No.	Invalid Input (xxx-xxx-xxxx)
Reference 2 Full Name:	Invalid Input
Phone No.	Invalid Input (xxx-xxx-xxxx)
Reference 3 Full Name:	Invalid Input
Phone No.	Invalid Input (xxx-xxx-xxxx)
Signature
I hereby certify that all entries are true and complete, and I agree and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part of any employment in the service of Eagle Protection Services, Inc.. I understand that all information on this application is subject to verification and I consent to criminal history background checks. I also consent that you may contact references, former employers and educational institutions listed regarding this application. I further authorize Eagle Protection Services, Inc. to rely upon and use, as it sees fit, any information received from such contacts. Information contained on this application may be disseminated to other government and nongovernmental organizations or systems on a need-to-know basis for good cause shown as determined by law or Eagle Protection Services, Inc.
I have read and understand the above. (You MUST type in capital letters "YES" to continue) (*)	Must confirm that you read terms.
I completed this application on: (*)	Must give the date of application. (mm/dd/yy)
	By clicking the SUBMIT button below I agree and understand that I am digitally signing this application for employment. Information about my computer and I.P. address are also being recorded with my consent.
Yes I agree to all the terms in this application for employment. (You MUST type in capital letters "YES" to continue) (*)	Must confirm that you read terms.
And your Initials in this box: (*)	Must initial here.