Guardian Security Services, Inc. Application For Employment: Please Complete This Form and Fax It To Us At: 212-645-4163

GUARDIAN SECURITY SERVICES, INC.
APPLICATION FOR EMPLOYMENT

PLEASE COMPLETE THIS FORM AND FAX IT TO US AT: 212-645-4163
IF YOU REQUIRE ADDITIONAL INFORMATION, PLEASE CONTACT US AT: 212-645-9500
GUARDIAN SECURITY SERVICE, INC. 161 AVENUE OF THE AMERICAS NEW YORK, NY 10013 T. (212) 645-9500 F.(212) 645-4163
APPLICANTS NAME: __________________________________
APPLICANTS ADDRESS: _ _________________________________
___________ _________________________
PHONE NUMBER: _(_____)
______________________________
APPLICANTS FORMER ADDRESS _ _______________
(IF ADDRESS HAS CHANGED IN THE LAST 5 YEARS):
_____________________
___________ _________________________
_ _
OTHER NAMES USED BY APPLICANT: _ ________________________
___________ _________________________
I herby authorize any person, educational institution, organization, company, employer, association, etc. that has information about me pursuant to my application for employment, to disclose that information regarding my qualifications and fitness for employment. I hold Guardian Security Services Inc., you, your company, organization or association, former employers, educational institutions, and any other persons giving references or information, free of liability for the exchange of this information and any other reasonable and necessary information incidental to the employment process.
SIGNATURE: _______________
DATE: __________________
EMERGENCY CONTACT INFORMATION

SECURITY OFFICER: ________________________________________________
(Last) (First) (Middle)
SECURITY OFFICER ID: ___________
____
ADDRESS: __________________________________________________________
(Street) (Apt No.)
___________________________________________________________________
(City) (State) (Zip)
TELEPHONE NO: _______________
CELLULAR NO: __________________
IN CASE OF EMERGENCY, PLEASE CONTACT: NAME: _______________________________________ _________
ADDRESS: __________________________________________________________
(Street) (Apt No.)
_________________________________________________________ __________
TELEPHONE NO: _______________
CELLULAR NO: __________________
ALTERNATE CONTACT: NAME: ____________________________________ ____________
ADDRESS: __________________________________________________________
(Street) (Apt No.)
_________________________________________________________ __________
TELEPHONE NO: _______________
CELLULAR NO: __________________
OFFICERS SIGNATURE: __________
DATE: ____________
EMPLOYEE STATEMENT - SECURITY GUARD APPLICATION
ANSWER THE FOLLOWING QUESTIONS BY CHECKING EITHER YES or NO 1. Are you a citizen of the United States or a legal resident of the United States in possession of a valid alien registration card? YES NO
IF NO, you must attach an explanation.
2. Are you a peace officer? If Yes, please read the enclosed Security Guard Training Advisory YES NO
IF you qualify for an exemption, you must submit the documentation described in the Advisory. If you do not qualify, you must submit training certificates.
3. Are you a retired police officer? If Yes, please read the enclosed Security Guard Training Advisory. YES NO
IF you qualify for an exemption, you must submit the documentation described in the Advisory. If you do not qualify, you must submit training certificates.
4. Have you ever been convicted in this state or elsewhere of any criminal offense that is a misdemeanor or a felony? YES NO
IF YES, submit a written explanation giving the place, court jurisdiction, nature of the offense, sentence and/or other disposition. You must provide a copy of the accusatory instrument (e.g., indictment, criminal information or complaint) and a Certificate of Disposition. If you possess or have received a Certificate of Relief from Disabilities, Certificate of Good Conduct or Executive Pardon, you must provide a copy of same.
5. Are there any criminal charges (misdemeanors or felonies) pending against you in any court in this state or elsewhere? YES NO
IF YES, you must provide a copy of the accusatory instrument (e.g., indictment, criminal information or complaint).
6. Has any license or permit issued to you or a company in which you are or were a principal in New York State or elsewhere ever been revoked, suspended or denied? YES NO
IF YES, you must attach an explanation.
7. Have you ever been discharged from a correctional or law enforcement agency for incompetence or misconduct as determined by a court of competent jurisdiction, administrative hearing officer, administrative law judge, arbitrator, arbitration panel or other duly constituted tribunal, or resigned from such an agency while charged with misconduct or incompetence? YES NO
8. Have you ever been declared to be incompetent by reason of mental disease or defect which has not been removed by any court of competent jurisdiction? YES NO
9. Have you ever applied in this state or elsewhere for a registration/license as a security guard; watch, guard or patrol agency; or private investigator? YES NO
IF YES, you must attach an explanation and provide your UID# ___________________.
EMPLOYMENT HISTORY Below PRINT a complete record of your occupation during the last five (5) years. You may copy this page and attach as many sheets as needed. COMPANY I. _____________________
(Name of Company)
__________________
(Full Time/Part Time)
(Hours Worked Per Week)
_________ _________
_____________________
(Company Address)
__________________ __________________
(Supervisor)
_____________________
(Business Telephone)
From: _ To: _ ___ (Dates of Employment)
_____________________
(Position)
__________________
(Duties)
_________
COMPANY II. _____________________

(Name of Company)
__________________
_________ _________
_____________________
(Company Address)
__________________ __________________
(Supervisor)
_____________________
_____________________
(Position)
__________________
(Duties)
_________
COMPANY III. _____________________

(Name of Company)
__________________
_________ _________
_____________________
(Company Address)
__________________
_____________________
__________________
(Supervisor)
_____________________
(Position)
__________________
(Duties)
_________
COMPANY IV. _____________________

(Name of Company)
__________________
_________
_____________________
(Company Address)
__________________ __________________
(Supervisor)
_________
_____________________
_____________________
(Position)
__________________
(Duties)
_________
COMPANY V. _____________________
(Name of Company)
__________________
_________
_____________________
(Company Address)
__________________ __________________
(Supervisor)
_________
_____________________
_____________________
(Position)
__________________
(Duties)
_________
COMPANY VI. _____________________

(Name of Company)
__________________
_________
_____________________
(Company Address)
__________________
_________
_____________________
__________________
(Supervisor)
_____________________
(Position)
__________________
(Duties)
_________
CHILD SUPPORT STATEMENT you MUST complete this section. If you do not complete it, your application will NOT be processed. I, the undersigned, do hereby certify that (You must X A or B, below): A. [ ] I am not under obligation to pay child support. (SKIP B and go directly to Applicant Affirmation). B. [ ] I am under obligation to pay child support (You must X any of the four statements below that are true and apply to you):
[ ] I do not owe four or more months of child support payments.
[ ] I am making child support payments by income execution or court approved payment plan or by a plan agreed to by the parties. [ [ ] My child support obligation is the subject of a pending court proceeding. ] I receive public assistance or supplemental social security income.
Applicant Affirmation I affirm, under the penalties of perjury, that the statements made in this application are true and correct. I further affirm that I have read and understand the provisions of Article 7A of the General Business Law and the rules and regulations promulgated thereunder. SIGNATURE: _______________ DATE: __________________
Notice of EmploymentIf employment will commence with the filing of your application, this section must be completed by you employer. Date of Hire: /___/___ /___/___ /___/___/ /___/_ _/___
Transaction Number: Transaction Date:
/___/___/ /___
/___ -
Guards Social Security Number: ___/___/___ - _ _/__ - ___/___/___/___
Guards Name: ______________________________________________________ Employers UlD: /___/___/ /___/___/ /___/___/ /___
Employers Business Name: _
________________________________
I, , swear and affirm that I am the representative for the company identified the employer and that I have verified the statements made by this employee and determined that these statements are true and correct to the be of my ability. I further attest that based on my verification of these statements, I find that the employee listed hereon is qualified for employment.
GUARDIAN SECURITY INC. POLICY AND PROCEDURES FOR HARASSMENT COMPLAINTS Guardian Security Inc. has long been committed to maintaining a work environment that is free of harassment. In keeping with this commitment, we will not tolerate any form of harassment of Guardians employees by anyone, including any supervisor, co-worker, vendor, client, customer or member of the public. All individuals are entitled to be treated with respect and professionalism. Harassment consists of unwelcome conduct, whether verbal, physical, or visual, that is based on a persons protected status under the law, such as sex, color, race,, ancestry, religion, sexual orientation, national origin, age, physical handicap, medical condition, disability, marital status, veteran status, citizenship status, based on opposition to discrimination or harassment or other protected group status. Guardian will not tolerate harassing conduct that adversely affects wages, benefits, or other terms or conditions of employment, or unreasonably interferes with an individuals work performance, or that creates an intimidating, hostile, or offensive work environment. Sexual harassment is prohibited and deserves special attention. However, this policy and procedures apply to all forms of harassment. Unwelcome sexual advances, requests for sexual favors, and other physical, verbal, or visual conduct based on sex, constitute sexual harassment when (1) submission to or rejection of the conduct is an explicit or implicit term or condition of employment, (2) submission to or rejection of the conduct is used as the basis for an employment decision, or (3) the conduct has the purpose or effect of unreasonably interfering with an individuals work performance or creating an intimidating hostile, or offensive working environment. Examples of Sexual Harassment include: VERBAL: Sexual innuendo Suggestive comments or insults Humor or jokes about sex or gender-specific physical traits
NON-VERBAL: Suggestive or insulting sounds Leering or staring Whistling Obscene Gestures PHYSICAL: Touching or Pinching Brushing the Body Coerced sexual relations Assault
All employees of Guardian are responsible for helping to assure that we avoid harassment of any kind. If you experience or witness harassment, you are immediately to notify your immediate supervisor or other supervisor with whom you are comfortable speaking. If you are not comfortable advising any supervisor regarding harassment, you may call Mr. Alan Bressler or Mr. Brian Meagher at Guardian at 212-645-9500 to report the harassment. We cannot remedy a harassment problem if we are unaware that it happened. Guardian forbids retaliation against anyone who has reported harassment. It is Guardians policy to investigate all such complaints thoroughly and promptly. Guardian will keep all complaints and the terms of their resolution confidential to the fullest extent practicable. If an investigation confirms that harassment has occurred, Guardian will take corrective action, including such discipline up to and including immediate termination of employment, as appropriate. I have read the Guardian Security Harassment Policy and will abide by its terms
SIGNATURE: _______________
DATE: __________________
PRIMARY RESPONSIBILITIES FOR ALL SECURITY OFFICERS 1. Officers are expected to report for duty in uniform, at their assigned post, five (5) minutes before the beginning of each tour/shift. 2. Complete, proper uniforms are to be worn at all times while on duty. Uniforms are to be neat/clean. 3. Officers must sign in/out of each post at the end of their shifts/tours and shall report events and unusual incidents to relieving officers and Supervisors. 4. Security Officers shall familiarize themselves with all orders for their assigned post. Officers who do not understand are unsure of any aspect of their required responsibilities must immediately contact their security supervisor or security director for clarification. 5. Security Officers shall always be courteous and professional in carrying out their duties, and be especially courteous and professional in all interactions with building tenants. Officers shall be attentive to their surroundings and never allow themselves to become distracted. Sleeping while on duty is strictly prohibited. 6. Security Officers are strictly prohibited from using physical force. 7. Officers shall immediately report any unusual or unsafe condition to the security supervisor and building manager. Examples are: suspicious an/or irrational behavior, criminal behavior/acts, persons requiring medical attention, vendors working without taking precautionary measures, hazardous sidewalk conditions, wet floors, etc. 8. Officers are strictly prohibited from leaning/sitting, or standing with their hands in their pockets while at their posts. 9. Lunch and personal breaks will only taken at assigned times. Any deviation requires approval of the security supervisor, security director or designated building management representative. Under no circumstances can breaks be taken in tenant spaces. Use of tenant telephones, microwaves, copy machines, computers or any other equipment is strictly prohibited. 10. No personal bags containing such items as beverages, newspapers, books, etc are to be brought to the assigned work areas. All such items are to be left in the break room or other area designated by building management
11. No radio headsets, no cell phones or other entertainment devices are permitted to be worn or carried while officers are on post or in the building. 12. Smoking is not permitted in the building under any circumstances. 13. Building management or the shift supervisor (as authorized by management) may change or add additional duties as required. 14. Security officers shall comply with all instructions issued by the supervisor on duty, the security director or by the building management. 15. Security jobs require many skills and generally require standing post, without sitting or leaning for 8 hours or more, walking long distances, and climbing many flights of stairs. I understand that these are job requirements and I can do this work. In addition to the information outlined above, I have been issued and/or have read the complete general rules and regulations for performing guard duties. I affirm that I will follow the general rules and regulations and will follow any additional specific rules and regulations governing the site(s) to which I am assigned as a Guardian employee. SIGNATURE: _______________ PRINT NAME: _______________ DATE: __________________ SITE: __________________
Dear Security Officer Applicant, If you are employed by Guardian Security Service, Inc. and complete the required full-time employment period, you will have the opportunity to apply for medical insurance. The medical insurance policy is through a major carrier and covers major medical conditions requiring hospitalization. Currently, the weekly contribution that officers make toward their individual insurance premium is $25.00. This premium can change without notice. If you are interested in applying for this major medical insurance coverage, please sign the form below with the specific information requested. An insurance application form will be sent to you. If you are declining the insurance opportunity, please fill in the section of this sheet where it is marked DECLINE. If you decline to apply for medical insurance now, you can change your mind at a future date. You must then request an application in writing.
I WISH TO APPLY:
YOUR NAME: __________________________________________ ____________ I wish to apply for individual medical insurance coverage. I understand that Guardian Security Service pays a portion of the cost of coverage. I agree to have $20.00 deducted from my pay each week toward the insurance premium. The amount I contribute toward this premium may increase due to policy changes or increases in policy cost. SIGNATURE: _______________ ADDRESS: ___________ ____ DATE: __________________ PHONE: ________________
----------------------------------------------------------------------------------------------
I DECLINE TO APPLY:
YOUR NAME: __________________________________________ ____________ SIGNATURE: _______________ DATE: __________________
ADDRESS: ___________
____
PHONE: ________________
REQUEST FOR EMPLOYMENT VERIFICATION & BACKGROUND INFORMATION: HUMAN RESOURCES DEPARTMENT: Application Information Release I herby authorize any person, educational institution, organization, company, employer, association, etc. that has information about me pursuant to my application for employment, to disclose that information regarding my qualifications and fitness for employment. I hold Guardian Security Services Inc., you, your company organization or association, former employers, educational institutions, and any other persons giving references or information, free of liability for the exchange of this information and any other reasonable and necessary information incidental to the employment process. SIGNATURE: _______________ DO NOT FILL IN The Security Officer named below has applied to work for us. As part of our background investigation, the officer has authorized you to release information concerning employment with your organization. NAME: ________________________________
(Last) (First)
DATE: __________________
UID#: ____________________
ADDRESS: __________________________________________________________
(Street) (Apt No.)
___________________________________________________________________
TELEPHONE NO: _______________ DATES OF ACTUAL EMPLOYMENT: _____ JOB TITLE: __
DOB: __________________ TO ________________
HOURLY WAGE: _______ INCREASE DATE: ___

No No
Does the above information correspond with the info you have on file? Yes Was the individual terminated for cause? Yes
Does this individual qualify to be re-hired? Do you recommend this individual for employment? Did this individual operate a motor vehicle during work assignment?
Yes Yes Yes
No No No
COMMENTS: __________ _____________________________________________ ___________________________________________________________________ NAME: __________________________________ TITLE: ____________________ SIGNATURE: _____________________________ DATE: ____________________ CONSENT AND DISCLOSURE DATE: ________________________ LOCATION: _________________________
I understand that GUARDIAN SECURITY SERVICE., will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New York, NY 10011, as part of the procedure for processing my application for employment, also understand if my application for employment is granted, GUARDIAN SECURITY SERVICE may obtain further information through subsequent investigations by STERLING TESTING SYSTEMS, INC. so as to update, renew or extend my employment. I understand a consumer reporting agencys investigation may include obtaining information covering up to the last seven (7) years regarding, among other items, my credit background, references, character, driving record, past employment, work habits, education, general reputation, personal characteristics, mode of living, judgment and liens, subject to state and federal law. The investigation also may include obtaining information relating to criminal records without any time limitations, subject to state and federal law. In the event an investigative consumer report is conducted, I understand such information may be obtained by personal interviews with my acquaintances or associates or with others whom I am acquainted or who may have knowledge concerning my character, general reputation, persona characteristics or standard of living. I understand such information may also be obtained through direct or indirect contact with former employers schools; financial institutions, landlords and public agencies or other persons who may have such knowledge. I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five days after the Company receives my request or five days after the investigative consumer report was requested, whichever is later. By checking the box, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an investigation consumer report. I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act
I also understand that before I am denied employment based, in whole or part, on information obtained in the investigative consumer report, I will I provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act I understand if I disagree with the accurate of any information in the report, I must notify GUARDIAN SECURITY SERVICE within five business days of my receipt of the report. If I notify GUARDIAN SECURITY SERVICE with five business days of the receipt of the report that I am challenging information in the report, GUARDIAN SECURITY SERVICE will not make a final decision on employment status until after I have had a reasonable opportunity to address the information contained in the report I hereby consent to this investigation and authorize GUARDIAN SECURITY SERVICE to procure an investigative consumer report on my background as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am voluntarily releasing I date of birth for my own benefit and fully understand that age is not a consideration of employment. *Please Print FIRST NAME: _________________ ___ LAST NAME: ________________ OTHER NAME(S): _____________ CURRENT ADDRESS: _____________ ____ DOB: ___
_____ ____
MIDDLE NAME: ____ SEX: __ YRS: _
___ _ _
____
____
___________________________________________________________________
PREVIOUS ADDRESS: _____________
___
____
YRS: _
___________________________________________________________________
DRIVERS LIC. NO: _______ ___
STATE: __
SS#: ______
_ ___
SIGNATURE: _______________
DATE: __________________
Minnesota & Oklahoma applicants Only: I have the right to request a copy of my consumer report from Sterling Testing Systems, Inc. by checking below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make a written request consumer reporting agency to
provide me with a complete and accurate disclosure of the nature and scope of the consumer report. I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
Guardian Security Guards
I have been Issued and read the General Rules and Regulations for performing Guard Duties.
SIGNATURE: _______________
DATE: __________________
Security Officer Screening & Drug Testing Fee
A $130.00 cost will be deducted from your wages in increment on becoming a security officer with Guardian Security for screening for employment. This will be reimbursed to you if you successfully complete the 90 days probation period.
SIGNATURE: _______________
DATE: __________________

Guardian Security Services, Inc. Application For Employment: Please Complete This Form and Fax It To Us At: 212-645-4163

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Guardian Security Services, Inc. Application For Employment: Please Complete This Form and Fax It To Us At: 212-645-4163

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GUARDIAN SECURITY SERVICES, INC.

APPLICATION FOR EMPLOYMENT

IF YOU REQUIRE ADDITIONAL INFORMATION, PLEASE CONTACT US AT: 212-645-9500

APPLICANTS NAME: __________________________________

APPLICANTS ADDRESS: _ _________________________________

PHONE NUMBER: _(_____)

APPLICANTS FORMER ADDRESS _ _______________

(IF ADDRESS HAS CHANGED IN THE LAST 5 YEARS):

OTHER NAMES USED BY APPLICANT: _ ________________________

EMERGENCY CONTACT INFORMATION

SECURITY OFFICER ID: ___________

TELEPHONE NO: _______________

CELLULAR NO: __________________

IN CASE OF EMERGENCY, PLEASE CONTACT: NAME: _______________________________________ _________

TELEPHONE NO: _______________

CELLULAR NO: __________________

ALTERNATE CONTACT: NAME: ____________________________________ ____________

TELEPHONE NO: _______________

CELLULAR NO: __________________

OFFICERS SIGNATURE: __________

EMPLOYEE STATEMENT - SECURITY GUARD APPLICATION

(Hours Worked Per Week)

From: _ To: _ ___ (Dates of Employment)

COMPANY II. _____________________

(Hours Worked Per Week)

From: _ To: _ ___ (Dates of Employment)

COMPANY III. _____________________

(Hours Worked Per Week)

From: _ To: _ ___ (Dates of Employment)

COMPANY IV. _____________________

COMPANY VI. _____________________

From: _ To: _ ___ (Dates of Employment)

Transaction Number: Transaction Date:

Guards Social Security Number: ___/___/___ - _ _/__ - ___/___/___/___

Guards Name: ______________________________________________________ Employers UlD: /___/___/ /___/___/ /___/___/ /___

Employers Business Name: _

TELEPHONE NO: _______________ DATES OF ACTUAL EMPLOYMENT: _____ JOB TITLE: __

DOB: __________________ TO ________________

HOURLY WAGE: _______ INCREASE DATE: ___

Yes Yes Yes

MIDDLE NAME: ____ SEX: __ YRS: _

PREVIOUS ADDRESS: _____________

DRIVERS LIC. NO: _______ ___

Guardian Security Guards

Security Officer Screening & Drug Testing Fee

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IN CASE OF EMERGENCY, PLEASE CONTACT: NAME: _______________________________ _

ALTERNATE CONTACT: NAME: ________________________

Guards Social Security Number: _/_/___ - _ _/ - _/_/_/___

Guards Name: ____________________________________________________ Employers UlD: /_/_/ /_/_/ /_/_/ /_

TELEPHONE NO: _____________ DATES OF ACTUAL EMPLOYMENT: _ JOB TITLE:

DOB: __ TO

HOURLY WAGE: _____ INCREASE DATE: _

MIDDLE NAME: __ SEX: YRS: _

DRIVERS LIC. NO: _____ _