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?
Other Than Minor Traffic Violations, Have You Ever Been Convicted of Any Crime (Including Military Court Martial)? * Yes
No
If Yes, Explain.
If Yes, In What Court?

A CONVICTION WIL NOT NECESSARILY DISQUALIFY YOU FOR THE JOB APPLIED FOR

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

Company *
Phone
Address
Position *
From
To
Supervisor Name
Starting Salary
Ending Salary
Reason for Leaving
 
Company
Phone
Address
Position
From
To
Supervisor Name
Starting Salary
Ending Salary
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