Central Missouri Security 
& Executive Protection LLC,

Servicing the Great state of Missouri One City at a time
 with all their Security Needs!!!! 

                                              Central Missouri Security And Executive Protection Services LLC,

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Position Applying For:_______________________________________________


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                                                                        EMPLOYEE INFORMATION

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Name:

Last MI______________________________________   First_________________________________________


Telephone:__________________________________ Email:_______________________________________


Alternate telephone:___________________________________


Address:____________________________________________ City__________________________________ Zip_______________


Are you willing to work overtime? YES _______   NO_________


Driver's License Number:________________________________ State:_________


If necessary for the job are you older than 21: YES________ NO________


I am legally eligible for employment in the U.S.? YES_______ NO_______


I am seeking a permanent position: YES________ NO______


I can work the following shifts: (check all that apply)


Any________ Day________ Night_______ Evening______ Split______


I will be able to start ______ days after being notified I am hired.

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                                                                           EMPLOYMENT HISTORY

List most recent employment first. Include summer or temporary jobs. Be sure all your experience or

employers related to this job are listed here, in the summary following this section or on an extra sheet

of paper if necessary. No more than 10 years history recommended.

______________________________________________________________________________________________________________________


Employer name and address:_____________________________________________________________


Position title/duties, skills:________________________________________________________________


Start date:____________________________________________


End date:_____________________________________________


Reason for leaving:______________________________________


Pay: $_______________________


Supervisor:_________________________________________________________


Telephone:________________________________________________

______________________________________________________________________________________________________________________


Employer name and address:______________________________________________________________


Position title/duties, skills:_______________________________________________________


Start date:________________________________________


End date:____________________________________


Reason for leaving:_________________________________________


Pay: $____________________________


Supervisor:________________________________________________


Telephone:___________________________________________

______________________________________________________________________________________________________________________


Employer name and address:_______________________________________________________


Position title/duties, skills:___________________________________________________________


Start date:__________________________________


End date:___________________________________


Reason for leaving:_______________________________________


Pay: $__________________________


Supervisor:________________________________________________


Telephone:___________________________________

______________________________________________________________________________________________________________________


Employer name and address:______________________________________________________________


Position title/duties, skills:_____________________________________________________


Start date:___________________________


End date:____________________________


Reason for leaving:_______________________________________________


Pay: $____________________________________


Supervisor:__________________________________________________


Telephone:__________________________________

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                                                                                             EDUCATION

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High school___________________________________ Graduated_____________________________


GED_______________________________________________


College/University___________________________________________


Business/technical__________________________________________________


Graduate or degree YES_________ NO___________

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                                                                                       MILITARY

______________________________________________________________________________________________________________________


Are you a veteran? YES_______ NO________


Branch; __________________________________________________


From_______________________ TO___________________________

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                                                                                 SKILLS & QUALIFICATIONS

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Other qualifications such as special skills, abilities or honors that should be considered:

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Types of computers, software, and other equipment you are qualified to operate or repair:

__________________________________________________________________________________________________________


Professional licenses, certifications or registrations:

__________________________________________________________________________________________________________


Additional skills, including supervision skills, other languages or information regarding the

career/occupation you wish to bring to the employer’s attention:______________________________________________________


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                                                                                   REFERENCES

______________________________________________________________________________________________________________________


List two personal references who are not relatives or former supervisors.


Name____________________________________________________


Address__________________________________________________________


Telephone________________________________________________


Occupation_______________________________________________


Years known_________________


Name_________________________________________________________


Address______________________________________________________


Telephone______________________________________


Occupation______________________________________


Years known________________________


Name_______________________________________________________


Address______________________________________________________


Telephone_______________________________________


Occupation______________________________________


Years known___________________

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                                                                 In case of accident or illness, please contact

______________________________________________________________________________________________________________________


Name:______________________________________________________


Daytime phone:______________________________________


Address:___________________________________________________________


Relationship:__________________________________

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                                                                          INFORMATION TO THE APPLICANT

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As part of our procedure for processing your employment application, your personal and employment

references may be checked. If you have misrepresented or omitted any facts on this application, and are

subsequently hired, you may be discharged from your job. You may make a written request for

information derived from the checking of your references.


Signature of Applicant; _______________________________________________________


Date; __________________________