PCI Security Employment Application Form Phase I

PCI Security Employment Application Form

Please read carefully before beginning the application.
1. As part of this application you will be required to answer if you have worked for a company by the name of KKP Security Group or its subsidiaries to include Critial Intervention Services or CIS If you have been previously employed by this company you must disclose the dates of employment. If you have worked for the company within the past two (2) years, notify the staff and do not continue with this application.

2. You will be required to provide a copy of your Driver's License and a copy of your Security License(s) to the front desk staff as well as fields in the application (Or Uploaded into the application if filling out remotely). Please make sure you have these available. If you do not have these documents ready you WILL NOT be able to complete this application.

3. Please Do Not press the "Submit" button untill you have completed the entire application.

4. Click the "Next" button to continue to the next page.
I have read and understand the instructions for this application.*

Yes
Please press "Next" when you're ready to begin
Please verify that you are human*

EMPLOYEE APPLICATION
Name*

First NameMiddle NameLast Name
Other Names Used (alias, maiden, nickname)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
SSN*
Position Applying For*
Driver’s License Number *
State Issued*
Cell phone number*
Please enter a valid phone number. Note by providing your cell phone number you agree we may text you updates your application status/employment status. This data is not shared with anyone outside of the organization and you may opt out any time by replying stop to any correspondence.
Who is your Phone Provider*
Home Number
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Upload a Picture of your Driver's License (Not Required if filling out in office)

Cancelof
Email*
example@example.com
Today's Date*

MonthDayYear
Date
Signature of applicant*

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Have you ever worked for KKP Security Group or its Subsidiaries to include: Critical Intervention Services also known as CIS, Aegis Protective Services, CIS Government Services, CISTech, or S2 Institute?*

YesNo
If You Answered Yes to this question when was your last date of employment?

MonthDayYear
Date
Signature (By Signing you acknowledge your answers to this inquiry are truthful to the best of yoru abilities)*

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PERSONNEL INFORMATION
Name*

First NameLast Name
Date first available for work.

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home phone number
Please enter a valid phone number.
Drivers License Number*
Date of Birth

MonthDayYear
Date
In Case of Emergency
Emergency Contact 1 Name*

First NameLast Name
Relationship*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home/Cell*
Please enter a valid phone number.
Emergency Contact 2 Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home/Cell
Please enter a valid phone number.
Personal Background (Optional)

This section is optional and will not affect employment decision
Gender

MaleFemaleOther
Race/Ethnicity

African American/BlackCaucasianAsianHispanicNative AmericanOther
Please read carefully
I understand it is my responsibility to notify the company of any change of address or other pertinent information.
Signature*

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Date*

MonthDayYear
Date

Application Acknowledgement
I Type Your Name* (Full name), hereby acknowledge that I have answered all questions in this application truthfully and correctly to the best of my abilities. I also acknowledge that any wilful omissions or mistruths in this application can result in my immediate termination and/or civil action.
Signature*

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Date Signed*

MonthDayYear
Date
If you noticed any mistakes or problems with the application, please report it here. Thank you for your feedback!
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PCI Security Employment Application Form