Fields marked with an asterisk (*) must be filled out before submitting.

Personal Details

First Name *
Last Name *
Email Address *
Social Security Number *
Drivers License Number
Expiration

Contact Details

Address *
City *
State *
Zip Code *
Telephone *
Cell phone

Qualifications

Are You Over 18 Of Age? * Yes
No
Can You Submit Proof of US Citizenship? * Yes
No
How Long Have You Been a Resident of CA?
Do You Have Reliable Transportation? * Yes
No
Do You Hold a State Reg. Guard Card? Yes
No
If So, Number:
If So, Expiration:
Do You Hold a State Firearms Card? Yes
No
If So, Number:
If So, Expiration:
Are You Employed at Present? Yes
No
If Yes, May We Contact Your Present Employer? Yes
No
US Military Status: Branch of Service
Highest Rank or Rating
Copy of DD214? Yes
No
Period of Active Duty: From
Period of Active Duty: To
Present Selective Service Classification
 
Home Addresses For the Past 10 Years – List Present Address First

Education Record

Name of School *
Address of Institution *
Course or Degree *

References – DO NOT Include Relatives or Employers

Name & Address
Home Phone
Occupation/Company & Address
Business Phone

Other Questions

Have You Ever Had Security Clearance? * Yes
No
If Yes, When & What Level?
Do You Have Any Physical Condition or Handicap Which May Limit Your Ability To Perform The Job? * Yes
No
If Yes, What Can Be Done To Accommodate Your Limitation?

List Entire Employment For Last 10 Years – Include Military & Volunteer Work

Company *
Phone
Address
Position *
From
To
Supervisor Name
Reason for Leaving
 
Company
Phone
Address
Position
From
To
Supervisor Name
Reason for Leaving
 
Attach Resume if Additional Space is Needed

Area

Select Preferred Location * Santa Maria
Santa Barbara
San Luis Obispo
Ventura
Five Cities Area
Lompoc
Atascadero
Paso Robles