I understand that neither this application nor any communication by a management representative is intended to create or does create a contract of employment offer, or promise of employment for a definite term. I acknowledge that if hired by the Company, employment is on an at-will basis in accordance with State law. This means the Company is free to terminate my employment at any time, with or without cause or advance notice, in accordance with State law, I am free to terminate my employment with the Company at any time for any reason, this at-will provision may be modified or waived only in a written agreement signed by an authorized representative of the Company and me. I agree to conform to the rules and regulations of the Company, and I understand that the company has complete discretion to modify such rules and regulations at any time, except that it will not modify its policy of employment at-will or its arbitration policy, if any.

We are an equal opportunity employer. Applicants are considered for positions without regard to race, religion, sex, national origin, age, disability, or any other consideration made unlawful by applicable federal, state, or local laws.

Fields marked with a '*' are required.

Date :
First Name *:
Middle Name:
Last Name *:
Address 1 *:
Address 2:
City *:
State/Province *:
Zip/Postal Code *:
Phone *:
Alternate/Cell Phone :
Position Desired *:	Sales Representative Access Control Technician Central Station Operator
Desired Salary/Hourly Rate *:
Type of Employment Desired *
Full Time :	Shift Desired:
Part Time :	Hours Desired:
Seasonal :	Hours Desired:
Other :	Hours Desired:
If under the age of 18, can you produce the necessary work certificate at the time of employment?	Yes    No
Are you willing to work overtime? *	Yes    No
Date you can start work if hired *:
Have you previously applied for employment with The Protection Bureau? *	Yes    No
If yes, when and where did you apply?
Have you ever been employed by The Protection Bureau? *	Yes    No
If yes, provide dates of employment, location and reason for separation from employment.
How did you hear about us?
Instructions for answering the next two questions: District of Columbia and Washington applicants: Limit any response to the past ten (10) years. Arizona, District of Columbia, Illinois, Missouri, Rhode Island and Utah applicants: Do not respond to second questions regarding arrests. New York applicants: An ex-offender who is denied employment may, upon written request, receive a statement of the reason(s) for denial within 30 days of the applicant’s request for such information. All applicants: Do not include convictions that were sealed, eradicated, erased, annulled by a court, or expunged, or convictions that resulted in referral to a diversion program.
Have you ever plead guilty or no contest to, or been convicted of any criminal offense other than the applicable exceptions listed above? *	Yes    No
Have you ever been arrested for any matters for which you are out on bail or on your own recognizance pending trial? *	Yes    No
CRIMINAL OFFENSES ONLY: If you answered Yes, to either of the above two questions, please provide the date(s) and explain in accordance with the above instructions so that individual circumstances can be considered.
Criminal convictions or arrests will not automatically disqualify an applicant from a particular job. The Company will consider the nature of the crime, its seriousness, whether the conviction(s) substantially relates to the position’s functions and qualifications, the frequency of convictions, the applicant’s age at the time of conviction, the time elapsed since the date of conviction or completion of jail sentence, the applicant’s entire work and educational history, and employment references and recommendations.
Have you ever initiated an act of violence in the workplace? *	Yes    No
If Yes, please provide the date(s) and explain so that individual circumstances can be considered. (A “Yes” answer will not necessarily disqualify you from employment.)
Education And Experience: Education School Name & Location Course Of Study Did You Graduate? # Of Years Completed Degree/Major High School * College Bus/Tech/Trade or Post College
Honors Received:
Is any additional information relative to change of name, use of an assumed name, or nickname necessary to enable a check on your work and educational record?
Current Certifications Held:
Proficiences
MS Outlook: Never Used   Casual Use   Moderate   Intermediate   Advanced MS Excel: Never Used   Casual Use   Moderate   Intermediate   Advanced MS Word: Never Used   Casual Use   Moderate   Intermediate   Advanced MS Power Point: Never Used   Casual Use   Moderate   Intermediate   Advanced MS Access or other database: Never Used   Casual Use   Moderate   Intermediate   Advanced Networking: Never Used   Casual Use   Moderate   Intermediate   Advanced
Work Experience Please list the names of your present or previous employers in chronological order with present or last employer listed first. Account for all periods of time including any period of unemployment. If self-employed, supply firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Our failure to completely respond to each inquiry may disqualify you for future consideration from employment.
Name Of Company *:
Address, City, State, Zip *:
Job Title *:
Duties/Responsibilities *:
Date Employed From *:
Date Employed To *:
Starting Wages *:
Ending/Current Wages *:
Name of Supervisor *:
Phone *:
May We Contact? :	Yes    No
If 'No,' Please Explain:
Reason For Leaving :
What will this employer say was the reason for your employment terminated? :
Name Of Company :
Address, City, State, Zip :
Job Title :
Duties/Responsibilities:
Date Employed From :
Date Employed To :
Starting Wages :
Ending/Current Wages :
Name of Supervisor :
Phone :
May We Contact? :	Yes    No
If 'No,' Please Explain:
Reason For Leaving :
What will this employer say was the reason for your employment terminated? :
Name Of Company :
Address, City, State, Zip :
Job Title :
Duties/Responsibilities:
Date Employed From :
Date Employed To :
Starting Wages :
Ending/Current Wages :
Name of Supervisor :
Phone :
May We Contact? :	Yes    No
If 'No,' Please Explain:
Reason For Leaving :
What will this employer say was the reason for your employment terminated? :
I authorize the Company or its agents to confirm all statements contained in this application and/or resume as it relates to the position I am seeking and to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization forms for the background investigation. I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this Company employs only individuals who are legally eligible to work in the United States for this Company. THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF SIXTY (60) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY. I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE, ACCURATE AND COMPLETE. BY SUBMITTING THE INFORMATION OF THIS FORM, I CERTIFY THAT I AM AT LEAST 18 YEARS OF AGE. UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSEPCTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100. I have read and understand the above statement. UNDER MASSACHUSETTS LAW, IT IS UNLAWFUL FOR AN EMPLOYER TO REQUIRE OR TO ADMINISTER A LIE DETECTOR TEST AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. FEDERAL AND/OR STATE LAW MAY PROHIBIT THE USE OF POLYGRAPH OR SIMILAR TESTS AS WELL. THIS APPLICATION MAY NOT BE APPLICABLE FOR ALL INDUSTRIES.