West Coast Offices:
PO Box 5640
Huntington Beach, CA 92646


East Coast Offices:
1111 Brickell Ave., 11th Floor
Miami, FL 33131


Nationwide Toll Free Telephone: (888) 926-8110
Calling from Outside the U.S.: +1 714-352-7190


Your Information:
Name              Soc. Sec. No 
Present Address      Lived Here Since
City     State     Zip/Postal Code     Country
Home Phone Number      Work Phone Number     Cell Phone Number
Fax Number      Email Address

Federal And State Laws Prohibit Discrimination In Employment Because Of Sex, Age, Color, Religious Creed, Marital Status, National Origin, Ancestry, Height, Weight, Unfavorable Discharge From Military Service Or Non-Job Related Handicap Or Disability.
General Information:
Were You Previous Employed By This Firm?    
If Yes, When?             Division
Name(s) of Any of our employees with whom you are related 
Who referred you for employment?  
Position(s) Applied For            
If Part Time, Specify Days and Hours:
Are you legally eligible for employment in the United States?    
State Reason, If Ever Denied Bonding  
Have you ever been convicted of a felony?    
If Yes, When:      If Yes, Explain  
Have you ever been convicted of a misdemeanor?    
If Yes, When:      If Yes, Explain  
Do you have the ability, with or without reasonable accommodation, to perform the essential job functions of the position for which you are applying?    
Name Address Dates Attended Date Grad. G.P.A. Major Degree
High School
Grad School
Other (specify)

Special Skills Training:
List type & amount of practical training and/or experience you have in security:
If applicable, list your approximate speed in:
(WPM)       Shorthand (WPM)       Key Entry Strokes
List any other skills, courses, programs, or seminars pertinent to your application:

Military Record:
Branch of Service     Dates of Service       Rank At Discharge
Duties While In Service  
Currently In:            

Security Experience:
BSIS PI #   Expires On
BSIS PPO #   Expires On
California CCW #   Expires On
Firearm Qualification #   Expires On
Guard Registration #   Expires On
Have you ever had E.P. Training?    
If yes, when?      If Yes, Explain  
Are you a retired L.E.O?    
If yes, what department?       When did you retire?   
Are you an active duty L.E.O?    
If yes, what department?       How many years?   
Do you have permission to work off-duty?