IBS Security - Central Ohio's Security Solution

Application for Employment

Social Security# --

Date: 1/7/2009

Name:		,
	(Last)	(First)	(Middle)

Address:
	(Street)	(City)	(State)	(Zip)

Telephone: () -

E-Mail Address:

Are you 18 years of age or older? Yes No

If hired, can you provide written evidence that you are authorized to work in the U.S.? Yes No

Education:

Type	Name & Address	Course of Study	Years Completed	Degree/ Diploma
High School

College

Technical

Other

Employment Record:

Company Name & Address	Phone	Contact Name	Dates of Employment	Reason for Leaving
1.			To:
			From:
2.			To:
			From:
3.			To:
			From:
4.			To:
			From:

United States Military Service:

Branch of Service:

From:

To:

Rank & Type of Service:

Training/Experience Received:

References (Do Not Use Relatives)

Name & Address	Phone	Occupation	Relationship	Years Known
1.

2.

3.

Employment:

Position applying for:

Salary desired:

Applying for: Full-time Part-time

Date available:

How were you referred to our organization?

Do you have any relatives who are employed by this organization? Yes No

If Yes, please list:

Have you ever used/worked under a different name or alias? Yes No

If Yes, please list:

Have you ever been convicted of a crime other than traffic violations? Yes No

If Yes, please list:

Please list any additional information that relates to your ability to perform the job for which you have applied such as licenses, professional memberships, skills, etc.

Applicant's Statement

I understand that IBS, Inc. follows an "employment at will" policy, in that I or IBS, Inc. may terminate my employment at any time, or for any reason consistent with applicable state or federal law. This "employment at will" policy cannot be changed verbally or in writing, unless the change is specifically authorized in writing by an officer of IBS, Inc. I understand that this application is not a contract of employment. I understand that federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity. Failure to submit such proof will result in denial of employment.

I understand this application will be active for a period of one year. After that time, if I wish to be considered for employment, I must submit a new application.

I understand that the employer will thoroughly investigate my work and personal history and verify all data given on this application, on related papers and in interviews as agreed to in the attached Background Check Authorization (Release) Form.

I also understand that IBS, Inc. follows a Drug Free Work Environment and that random drug screens may be administered at any time.Upon my employment, I also consent to a pre-employment drug screen.

Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, disability or veteran status.

I certify that all the statements herein are true and understand that any falsification of willful omission shall be sufficient cause for dismissal or refusal of employment.

I understand that by submitting and accepting this document I am bound by the terms above: