All Star Security Group Application and Questionnaire

I certify that all information provided by me on this information sheet is true and complete to the best of my knowledge and that I have withheld nothing that, if disclosed, would alter the integrity of this application.

I understand that I will work as an INDEPENDENT CONTRACTOR which means that either I or this company can terminate the contract relationship at any time for any reason not prohibited by statute. I hereby acknowledge that I have read and understand the above statements.

Please review your information for accuracy.

I have reviewed all my information, and all is complete and correct.

As part of AllStar Security Group, we perform a hiring background and investigation, we may obtain consumer reports or prepare an investigative consumer report. The investigative consumer report may consist of contacting all listed prior employers to verify your employment history. It may also include, but not limited to, credit information reports, criminal history reports, and driving history records. Under the provisions of the Fair Credit Reporting Act (15 USC at 1681-1681u) as amended, before we can seek such records, we must have written permission to obtain the information. You have the right, upon written request, to a complete and accurate disclosure of the nature and scope of the investigation. You are also entitled to a copy of your Rights Under the Fair Credit Reporting Act.

I do hereby authorize verification of all information in my employment application from all sources of employment, education, motor vehicle, financial history, criminal history, personal character, and worker's compensation records in compliance with ADA, labor and wage records, etc. or any part thereof, and authorize any duly authorized agent to obtain, whether the said records are public or private, and including those which may be deemed to be privileged or confidential in nature and I release all persons from liability on account of such disclosures, information appearing on this suitability for employment. I certify that I have made true, correct, and complete answers and statements on my employment application, any supplements to it and interview in the knowledge that they will be relied upon in considering my application for employment. I agree to provide additional information that may be requested to process my employment application. I authorize without reservation any part or agency connected to furnish the above-mentioned information. This authorization is valid during the course of my employment to the extent permitted by law.

I hereby do authorize you to contact my current employer for Employment and Reference Verification. (This will authorize immediate inquiries to the Human Resources Department and to any listed supervisors or references in the Employment/References section of your application.)

I have the right, upon proper identification, to request the nature and substance of all information into files on me at the time of my request, including sources of information, and the recipients of any reports on me which has been previously furnished within the two year period preceding my request.

I understand and agree that any omission, false statement, misleading statement, or answer made by me on my application or any supplements to it and in any interviews, will be sufficient grounds for rejection of employment and my discharge after employment.

I hereby agree, upon a request made under the drug/alcohol testing policy of Allstar Security Group, to submit to a drug or alcohol test and to furnigh a sample of my urine, breath, and/or blood for analysis. I understand and agree that if I at any time refuse to submit to a drug or alcohol test under company policy, or if I otherwise fail to cooperate with the testing procedures, I will be subject to immediate termination. I further authorize and give full permission to have the Company and/or its company physician send the specimen or specimens so collected to a laboratory for a screening test for the presence of any prohibited substances under the policy, and for the laboratory or other testing facility to release any and all documentation relating to such test to the Company and/or to any governmental entity involved in a legal proceeding or investigation connected with the test. Finally, I authorize the Company to disclose any documentation relating to such test to any governmental entity involved in a legal proceeding or investigation connected with the test.

I understand that only duly-authorized Company officers, employees, and agents will have access to information furnished or obtained in connection with the test; that they will maintain and protect the confidentiality of such information to the greatest extent possible; and that they will share such information only to the extent necessary to make employment decisions and to respond to inquiries or notices from government entities.

l will hold harmless the Company, its company physician, and any testing laboratory the Company might use, meaning that I will not sue or hold responsible such parties for any alleged harm to me that might result from such testing, including loss of employment or any other kind of adverse job action that might arise as a result of the drug or alcohol test, even if a Company or laboratory representative makes en error in the administration or analysis of the test or the reporting of the results. I will further hold harmless the Company, its company physician, and any testing laboratory the Company might use for any alleged harm to me that might result from the release or use of information or documentation relating to the drug or alcohol test, as long as the release or use of information or documentation relating to the drug or alcohol test, as long as the release or use of the information is within the scope of this policy and the procedures as explained in the paragraph above. 

This policy and authorization have been explained to me in a language I understand, and I have been told that if I have any questions about the test or the policy, they will be answered.

I UNDERSTAND THAT THE COMPANY WILL REQUIRE A DRUG SCREEN AND/OR ALCOHOL TEST UNDER THIS POLICY WHENEVER I AM INVOLVED IN AN ON-THE-JOB ACCIDENT OR INJURY UNDER CIRCUMSTANCES THAT SUGGEST POSSIBLE INVOLVEMENT OR INFLUENCE OF DRUGS OR ALCOHOL IN THE ACCIDENT OR INJURY EVENT, AND I AGREE TO SUBMIT TO ANY SUCH TEST.

 I understand that all fees submitted to Private Security are non-refundable, are nontransferable and that, in accordance with Administrative Rule 35.23, I will have 90 days from the date of notice of a deficiency, to turn in all required documentation, supplemental information and/or fees or this application will be abandoned and I will be required to reapply.

I verify that the information proved is true and correct, and I understand that this is an official Government record and that any false statement made on this document or any other supplement provided to DPS may result in criminal prosecution.

I understand, any pending charges or conviction referred to above require the submission of the appropriate court documentation, with this application. Failure to report an arrest or conviction, late found by a fingerprint search, may result in denial or revocation of a license based on the material misstatement of fact in this application.

I acknowledge I have review the eligibility criteria of Texas Occupations Code 1702.113 and the definition of 'conviction' provided in 1702.371. In addition, I acknowledge I have reviewed the disqualifying offenses listed in Texas Administration Code 35.4.

I, as the renewing employee, have completed the required minimum hours of Department approved Continuing Education (CE) credits necessary for renewal of my registration.

I understand my application for renewal may be denied if I am either in default of a student loan or delinquent in the payment of child support (Texas Education Code, Chapter 57 or Texas Family Code, Chapter 232).

I certify that all information I provided in relation to this criminal history record check is true and accurate. I authorize the Texas Department of Public Safety (DPS) to access Texas and Federal criminal history record information that pertains to me and disseminate that information to the designated Authorized Agency or Qualified Entity with which I am or am seeking to be employed or to serve as a volunteer, through the DPS Fingerprint-based Applicant Clearinghouse of Texas and as authorized by Texas Government Code Chapter 411 and any other applicable State of Federal statute or policy. I authorize the Texas Department of Public safety to submit my fingerprints and other application information to the FBI to disclose potentially pertinent information to the DPS during the processing of this application and for as long hereafter as may be relevant to the activity for which this application is being submitted. I understand that the FBI may also retain my fingerprints and other applicant information in the FBI's permanent collection of fingerprints and related information, where all such data will be subject to comparisons against other submissions received by the FBI and to further disseminations by the FBI as may be authorized under the Privacy Act of 1974 (5 USC 553a). I understand my fingerprints will be searched by and against civil, criminal and latent fingerprints in the Next Generation Identifications (NGI) system. I understand that I am entitled to obtain a copy of any criminal history record check and challenge the accuracy and completeness of the information before a final determination is made by the Qualified Entity. I also understand the Qualified Entity may deny me access to children, the elderly, or individuals with disabilities until the criminal history record check is completed. If a need arises to challenge the FBI response, you many contact the agency that submitted the information to the FBI, or you may send a written challenge request to the FBI's Criminal Justice Information Service (CJIS) Division at the FBI CJIS Division, Attention Correspondence Group, 1000 Custer Hollow Rd, Clarksburg, WV 26306.