Pre-Application
Name: |
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Date: |
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Address: |
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Phone #: |
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Phone #: |
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main |
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secondary |
Social Security Number |
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At least 21 years of age? |
YES |
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NO |
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Place of birth? |
Email |
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Ever worked or applied to Weiser? |
NO |
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YES |
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(if YES give details on back.) |
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Full Time |
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(Must be available for all shifts) |
Part-time |
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Hours Available |
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Any Security experience? NO |
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YES |
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(where?) |
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Currently licensed/commissioned/registered for Security Officer? |
YES |
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NO |
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PREVIOUS EMPLOYMENT HISTORY |
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>>>> |
Most recent first. Go back 7 years |
<<<< |
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Name of Company |
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Phone |
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Dates: From - To |
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Reason for leaving |
1)
2)
3)
4)
5)
If more space is needed, use the back of this form
Ever been convicted of a crime? NO |
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YES |
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If YES, give details on back. |
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High School Graduate or GED?? |
YES |
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NO |
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Have reliable transportation to work site within 30 minutes of assignment? YES |
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NO |
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I would be willing to travel __________ |
miles one way to my assignment |
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Dates of Military Service ___________________________ |
Type of Discharge? |
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How did you hear about Weiser? |
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Weiser Security Services, Inc. conducts drug and alcohol use testing.
I authorize Weiser Security Services, Inc. to investigate my previous police record, work history, and any other aspect of my past deemed necessary. I understand that any questions not answered truthfully can lead to rejection of my application or termination.
X |
X |
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Date |
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Applicant's Signature |
THESE ARE ESSENTIAL FUNCTIONS OF THE POSITIONS OF SECURITY OFFICER
ARE YOU ABLE TO PERFORM THESE DUTIES,
WITH OR WITHOUT AN ACCOMODATION?
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Stand for a complete 8-12 hour shift. |
Y |
N |
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Walk carrying 5 pounds of equipment for an 8-12 hour shift. |
Y |
N |
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Climb a stairwell consisting of 10 flights, in an emergency. |
Y |
N |
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Squat and bend to read gauges. |
Y |
N |
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Climb in and out of a tractor trailer while conducting searches. |
Y |
N |
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Read ID Badges up to 3 feet away, regular print. |
Y |
N |
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Drive a vehicle continuously for an 8-12 hour shift. |
Y |
N |
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Endure temperature extremes for 8-12 hour shifts. |
Y |
N |
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Operate fire fighting equipment easily and quickly, after being trained. |
Y |
N |
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Respond to an emergency situation by moving quickly to investigate |
Y |
N |
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or use reasonable force to prevent a crime in progress. |
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Open and close 70 pound, 35 foot long gates. |
Y |
N |
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Lift or drag up to 150 pounds for 25 feet, in an emergency. |
Y |
N |
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Recognize through the sense of smell both usual and unusual odors. |
Y |
N |
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See, recognize, identify, and describe objects in poorly lighted areas. |
Y |
N |
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Hear, recognize and identify both usual and unusual sounds in noisy conditions. |
Y |
N |
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Weiser Security is a contract security guard company. Pay rates for security officers differ from job to job and from post assignment to post assignment depending on the contractual agreement established between Weiser Security and each of its Clients. Security officers are not guaranteed post assignments, hours per week, job duties, job titles, or any rates of pay above the current applicable state or federal minimum wage by Weiser Security. Weiser Security Reserves the right to transfer employees from one post assignment to another, or from one position or department to another, based on the needs of the Company and our Clients, at any time and for any reason consistent with federal, state and local law.
Conditional Offer of Employment
I understand that any offer of employment, if given, is conditional pending final inspection and approval of my personnel file by the Corporate Selection Controller.
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Applicant's Signature |
WEISER SECURITY SERVICES, INC.
The following statistical information is required for compliance with federal laws assuring Equal Employment Opportunity without regard to race, color, sex, national origin, religion, age or disability as well as the Vietnam Era Readjustment Act. The information requested is voluntary and will remain separate from your application for employment.
a. |
Today’s Date |
______ / ______ / ______ |
b. |
Social Security Number |
__________ / __________ / __________ |
c. |
Name: |
_________________________________________________ |
d. |
Position Applying For: |
_________________________________________________ |
e.EEO Codes (See Below)
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______ White |
______ |
American Indian/Alaskan Native |
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______ Black |
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______ Asian or Pacific Islander |
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______ Hispanic |
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Other |
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f. |
Male _______ |
Female _______ |
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g. |
Date of Birth ______ / ______ / ______ |
h.Do you have a disability - impairment which substantially limits one or more of your life
activities? YES _______ NO _______
i.Are you a disabled Veteran - 30% VA Compensation or discharge because of disability
incurred in line of duty? YES _______ NO _______
j.Are you a Vietnam Era Veteran - 180 days Active Duty between Aug. 15, 1964 and May 7,
1975? YES _______ NO _______
k.Please tell us how you heard about our opening?
❑Friend who works here. Name of friend: _____________________________________
❑Relative who works here. Name of relative:___________________________________
❑Simply called or walked in & asked about openings.
❑Advertisement. Name of publication with advertisement: ________________________
❑School. Name of School: _________________________________________________
❑Community Organization. Name of organization: ______________________________
❑Government Organization. Name of organization:______________________________
❑Employment Agency. Name of agency: ______________________________________
❑Other: ________________________________________________________________
____________________________________ |
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Applicant’s Signature |
4/00 WSS15 |