Career — CPS Patrol Employment Application

Employment Application

1887 S. Business Center Drive Suite 4C, San Bernardino, CA 92408
(24 Hour) (909) 890-2227 • Fax (909) 890-2577

Personal Information

Name (Last, First) *

Social Security #

Home Phone Number

Present Address

City / State / Zip

Permanent Address

Pager #

Cell Phone #

Employment Desired

Position *

Date You Can Start

Salary Desired

Are You Employed?

YesNo

Have You Ever Applied to This Company Before?

YesNo

Education

Grammar School

Address

Years Attended

Graduate?

YesNo

Subject Studied

High School

Address

Years Attended

Graduate?

YesNo

Subject Studied

College

Address

Years Attended

Graduate?

YesNo

Subject Studied

Trade School

Address

Years Attended

Graduate?

YesNo

Subject Studied

General

Subject of Special Study / Research Work or Special Training Skills

U.S. Military or Naval Service

Rank

References

Give below the names of three persons, not related to you and have known at least one year.

Reference 1

Name

Address

Phone #

Business

Years Known

Reference 2

Name

Address

Phone #

Business

Years Known

Reference 3

Name

Address

Phone #

Business

Years Known

Former Employers

List below three employers starting with the most recent one first.

Employer 1

Dates (Month/Year)

Name of Employer

Salary

Position

Reason for Leaving

Permits

Guard Card

Permit Number

Expiration Date

Temp Registration

Permit Number

Expiration Date

Firearm

Permit Number

Expiration Date

Side-Handle Baton (Pr-24)

Permit Number

Expiration Date

Expandable Baton

Permit Number

Expiration Date

Mace / Tear Gas

Permit Number

Expiration Date

C.P.R.

Permit Number

Expiration Date

First Aid

Permit Number

Expiration Date

Other Permits

Authorization

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

Signature *

Date

Rate Us

Evaluation Test — A

Please Print All Answers Clearly In Paragraph Form!

Name (Last, First)

Social Security #

1.) While patrolling a complex you notice a loose dog. At the same time you notice smoke coming from the other side of the building. What steps should you take?

2.) You are writing a parking citation and notice that this vehicle belongs to your mother-in-law. What are you going to do?

3.) While trying to issue a parking citation to a vehicle the owner becomes irate with you and challenges you to physical confrontation. Remember though that you are armed. What are you going to do?

4.) While patrolling you notice automobile glass on the parking area that you are patrolling, yet there are no cars. What are you going to do?

5.) While on patrol in your complex you hear a scream coming from within the complex next to you. What are you going to do?

6.) While on patrol of a gated complex at 0100 hours, you notice someone working on the inside of a vehicle, what are you going to do?

Autobiography

Please print clearly, short comments about your past, job history, and why you think you would make a good employee and any skills or talents not listed earlier.

Careers

Employment Application