Application Form

MILLENNIUM SECURITY SERVICES, INC.


3580 Wilshire Blvd, Suite #900-18
Los Angeles, CA 90010
Ph. 213 738 1875 Fx: 213 738 5537
www.millenniumsecurityservice.com


EMPLOYMENT APPLICATION

MILLENNIUM SECURITY SERVICES, INC. (MSSI) is an Equal Opportunity Employer.

All applicants receive consideration for employment without regard to race, color, religion, sex, age, national origin, handicap, veteran, marital status or medical condition.

False statements on this application shall be enough ground for termination.

Full Name:
       
UNARMED / ARMED
per hour
Day    Swing    Grave Yard     Rover
Sun Mon Tues Wed Thurs Fri Sat


   Full Time      Part Time       Temporary
   Yes       No
   Yes       No
   Yes       No
   Yes       No
   Yes       No       N/A
   Yes       No

EDUCATION

TYPE OF SCHOOL NAME OF SCHOOL LOCATION YEARS COMPLETED MAJOR OR DEGREE
High School
College
Business or Trade

   Yes       No
   Yes       No

(If yes, smoking on duty is not allowed, only during Lunch Break and in a permitted smoking area.)

   Yes       No
   Yes       No

EMPLOYMENT

STARTING WITH THE MOST RECENT, LIST ALL EMPLOYMENT FOR THE PAST 5 YEARS

(including part-time employment). All time must be accounted for. If unemployed for any time indicate by entering "Unemployed" in the 'Employer' field and enter the dates of unemployment. Use Additional Sheets if needed.

Employer name, Address, & Telephone # Date Position/Type of Work Name of Supervisor Reason for Leaving
From To
1
2
3
4
5

REFERENCES

Name (Last, First) & Address Relationship Telephone Number
1
2
3

MSSI AND APPLICANT UNDERSTANDING

I. I understand that this employment application is not to be construed as a guarantee of employment for a specific time, or as an express or implied contract of employment. I further understand that, should I become employed; my employment with MILLENNIUM SECURITY SERVICES, INC. will be terminated at will either by myself or MSSI at any time and for any reason or no reason at all. I further understand that the terms and conditions of employment, including company policies, procedures and benefits, may be modified at the sole discretion of MSSI with certification and with or without notice.
II. I understand that no representation, whether oral or written, by any representative or agent of MSSI, any time, can constitute an implied or: expressed contract of employment. I further understand that no representative or agent of MSSI has the authority to enter in an agreement for any specific period of time or to make any change in any policy, procedure, benefits or other terms or condition of employment other than in a signed document.
III. I understand any offer of employment I may receive is contingent upon my successful completion of the company's total pre-employment screening process, including the company receiving references it considers satisfactory, and my satisfactory completion of any pre-employment physical examination that company may require.
IV. I freely consent to and authorize any request to all my present and former employers and those individual I have listed as personal references to furnish information about my employment record, including but not limited to, statements about the reasons for the termination of my employment, work performance, abilities and other qualifications pertinent to my qualifications for employment. I hereby release my former employers and any individuals I have listed as personal references from any liability for damages arising from furnishing the requested information.
V. I freely consent to a physical examination and hereby release MSSI and the administrating medical facility from all liability arising from, or related to, such examination or the reporting of results to MSSI.
VI. This application was completed by me, and that all information is accurate and complete to the best of my knowledge. I understand that any misrepresentation or omission in regard to this application or interview(s) may result in an immediate termination of my employment at any time.
VII. I freely consent to produce documents that establish legal entry and lawfully allow me to be employed in the U.S.A
VIII. IF HIRED, I ACCEPT THE RESPONSIBILITY TO MAINTAIN CLEAN UNIFORMS, A PERFECT ATTENDANCE; TO REPORT TO WORK 15 MINUTES BEFORE MY SHIFT BEGINS, TO INQUIRE FOR DIRECTIONS TO MY POST, FOR MY SCHEDULE PRIOR TO MY SHIFT AND MORE IMPORTANTLY TO ABIDE BY COMPANY POLICIES AND RULES AND REGULATIONS OF THE ASSIGNED POST.