EmailMe Form - APSA Florida Employment Application

Personal Information

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Todays Date: *

MM / DD / YYYY

Are you at least 18 years or older? *

YES

NO

Full Legal Name: *

First Middle Last Suffix

Full legal name as listed on your government-issued driver's license, identification card, passport, etc.

Applicants Residential Address: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

This address should match the address on file with the Florida Department of Agriculture and Consumer Services. You can update your address online.

Social Security Number: *

Confirm

Date of Birth: *

MM / DD / YYYY

Drivers License / Identification Card: *

Confirm

Issued State: *

Confirm

Place of Birth City: *

Place of Birth State/Country: *

Email: *

Confirm

Primary Phone: *

### - ### - ####

Confirm

### - ### - ####

Alternate Phone

### - ### - ####

Confirm

### - ### - ####

How did you hear about us? *

If hired, can you supply evidence of a right to work in the United States? *

YES

NO

APSA Inc dba American Paratus Security Agency is a DHS E-Verify Participant.

Have you worked for American Paratus Security Agency before? *

YES

NO

If yes, when?

Do you have any friends or relatives employed by American Paratus Security Agency? *

YES

NO

If yes, please list names and relationships.

Education

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Do you have a High School Diploma or GED? *

YES

NO

Did you graduate from College or Technical School? *

YES

NO

Did not attend College or Technical School

If yes, Degree or Certificate?

When did you graduate?

College or Technical School Name:

College or Technical School Address:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Security Experience

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Florida State Licenses *

Please list your Florida Security License Numbers below.

Please list the State and License Number

Please list any out-of-state security licenses you may have.

Please list the State and License Number

Please list any other licenses or training certifications that you may possess:

Taser, ASP, Peper Spray Handcuffing, etc.

Military Experience

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Have you served in the Armed Forces of the United States? *

YES

NO

What Branch of Service?

What is your status?

A copy of DD Form 214 will be required during the interview.
Active Duty, USCG Auxilary & USAF Civil Air Patrol are not required to provide a DD Form 214.

Are you a member of the Florida State Guard?

No

Yes

Law Enforcement or Corrections Experience

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Have you completed a Law Enforcement or Corrections Acedemy the United States? *

YES

NO

Current Law Enforcement / Corrections Status

Active Corrections Officer

Active Law Enforcement Officer

Corrections Academy Graduate

Former Corrections Officer

Former Law Enforcement Officer

Law Enforcement Academy Graduate

Retired Corrections Officer

Retired Law Enforcement Officer

Check all that apply.

Law Enforcement Certification Type

Federal

Military

State

Certifying Agency

Certification / License Number

Criminal Background

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Have you EVER been ARRESTED, CHARGED OR CONVICTED of a violation of any LOCAL, STATE, OR FEDERAL LAW (other than minor traffic violations) or BEEN THE SUBJECT OF A DEFERRED ADJUDICATION?
(A conviction record will not necessarily be a bar to employment. This information will be used only for job-related purposes and only to the extent permitted by applicable law). *

YES

NO

If YES, please describe.

What did you do at your previous employer?

I hereby authorize American Paratus Security Agency and its designated agents and representatives to conduct a comprehensive review of my background, causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.
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I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me, to American Paratus Security Agency or its agents. I further authorize the complete release of any records or data pertaining to me, which the individual, company, firm, corporation, or public agency may have to include information or data received from other sources. American Paratus Security Agency and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicant’s personal information, including, but not limited to, addresses, social security numbers, and dates of birth. *

Agree

Disagree

Work Experience

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Are you currently employed? *

YES

NO

Start with your current or previous position. List previous 3 work experiences. A resume can be attached but may not be substituted for a completed application. Please list ONE job position per space.

Name of Current or previous employer #1:

City and State of last employer?

Job Title / Position

Brief description of job dutie:

What did you do at your previous employer?

Supervisor

Phone

### - ### - ####

From
Month / Year

MM / YY

To
Month / Year

MM / YY

Reason for leaving

May we contact this previous employer?

YES

NO

Name of previous employer #2:

City and State of last employer?

Job Title / Position

Brief description of job dutie:

What did you do at your previous employer?

Supervisor

Phone

### - ### - ####

From
Month / Year

MM / YY

To
Month / Year

MM / YY

Reason for leaving

May we contact this previous employer?

YES

NO

Name of previous employer #3:

City and State of last employer?

Job Title / Position

Brief description of job dutie:

What did you do at your previous employer?

Supervisor

Phone

### - ### - ####

To
Month / Year

MM / YY

From
Month / Year

MM / YY

Reason for leaving

May we contact this previous employer?

YES

NO

If you have a Resume, you may upload it here.

Position Information

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Positions Applying for? *

Pool Monitor (Non-Lifeguard)

Special Event Security

Un-Armed Security Officer

All positions require a Florida Class "D" Security License. Select all that apply.

Counties you are willing to work in? *

Employment type? *

Full-Time

On-Call

Part-Time

Special Events

Select all that apply

Transportation

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Do you have reliable transportation to work? *

YES

NO

If no, please describe

Does the vehicle you use have VALID insurance? *

YES

NO

My transportation does not require insurance

If no, please describe

Type of transportation? *

I hereby agree, upon a request made under the drug/alcohol testing policy of Emerald Coast Security Agency (the Company), to submit to a drug or alcohol test and to furnish 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 a 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.
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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.
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I 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 an 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 the information is within the scope of this policy and the procedures as explained in the paragraph above.
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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.
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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. *

Agree

Disagree

All interviews are conducted at the following offices located at the following address:

Panama City Beach
309 Richard Jackson Blvd.
Suite 214,
Panama City Beach, Fl 32407
Due to legal reasons, we cannot conduct phone or Zoom interviews.

Please select your preference. *

I understand and am willing to commute to the location for an interview.

I understand and am NOT willing to commute to this location for an interview.

I agree that all the information contained in this application are true and honest to the best of my knowledge. *

Agree

Disagree

Communication consent: *

I consent to receive text messages, SMS, emails, or phone calls related to my employment application.

Your information will not be shared with anyone outside of this agency.

Full Legal Name: *

First Middle Last Suffix

Full legal name as listed on your government-issued driver's license, identification card, passport, etc.

Signature *

Clear