Are You At Least 18 Years Of Age ? YesNo
Are you either a U.S. citizen or an alien who has legal right to work in the job for which you are applying ?YesNo
Have you ever been convicted of a crime that has not been expunged or sealed ? YesNo
(California Only - may exclude a marijuana related conviction thaat is more than (2) years old.)

Are you registered/licensed as a security officer in this state ? (where applicable) YesNo
If yes, give registraton/license number and expiration date 
If you are already registered/licensed as a security officer i this state, has your registration/license been revoked or suspended ? YesNo
if yes state reason(s), date of suspension or revocation, and date of reinstatement below.

Position applying for: 
Full time   Part time   Temporary 
Minimum salary required 

Have you ever applied to, or worked for McRoberts before ? YesNo
If yes, when ? 
What was the reason for leaving ? 
Do you speak, read, or understand any languages other than english which would aid you in the performance of your work duties ? YesNo
If yes, which languages 
Do you have any other experience, training , qualifications or skills which you feel make you especially suited for work at McRoberts Protective Agency, Inc.?YesNo
If so, explain by entering information below

Describe your duties and responsibilities at your last job

Are you reachable by phone ? YesNo  Are you reachable by beeper ? YesNo

Have your ever served as a member of the armed forces ? YesNo
If yes, What Branch ? 
Rank at separation : 
Type of Discharge ? 
Assignment: 
Have you obtained any special skills or abilities as a result of your services in the military ?

List below all present and past employment,starting with the most recent employer (go back 5 years).

Name of Employer : 
Address 
Position 
Dates of Employment (From/To)
Pay Rate 
Duties/Responsibilities 

Reason for Leaving: 

Supervisor's Name 
Telephone: 
Fax: 

EDUCATION HISTORY
[A] List last three (3) schools attended, starting with most recent [B] List number of years completed [C] Indicate degree or diploma earned, if any [D] Grade Point Average or Class Rank [E] Major field of study [F] Minor field of study (if applicable)

Educational Institute #1 

Educational Institute #2 

Educational Institute #3 

PLEASE READ CAREFULLY - Initial Each Paragraph And Sign Below

I have read and fully understand the questions asked in this application. I certify that all answers given by me are true, accurate and complete. I also understand that the omission and/or misrepresentation of any fact from this applicaton or during any interview for employment will be cause for immediate dismissal. I authorize McRoberts Protective Agency, Inc., to contact all my employment references, and to inquire about, investigate and obtain copies of any records which relate to me for my former employers and educational institutions I have attended. I hereby release McRoberts Protective Agency, Inc., and all affiliated entitties, as well as any person or institution that provided mcRoberts Protective Agency, Inc., with any information about me, from any and all liability whatsoever resulting from any such inquiry, investigation or communication

I agreeYesNo     Please print this form and initial here X_________________________________

I agreeYesNo     Please print this form and initial here X_________________________________

I hereby agree, as a condition of employment, unless provided otherwise by a collective bargaining agreement, to complete a binding arbitration agreement. (Please Print and Fax This Form To 212-425-2509)

Name: