Segura Security Services
1011 W. McCoy Lane
Santa Maria, CA 93455
Phone: (805) 349-0550
Toll Free: (800) 233-5333
Fax: (805) 922-7286
E-Mail: Segura@lightspeed.net
License # PPO10346

A Professional Private
Security Firm
Raul J. Segura,  CEO/CFO

Employment Application

As an EQUAL OPPORTUNITY EMPLOYER, Segura Security Services' policies, as well as Federal and State laws, prohibit discrimination in employment, including but not limited to, discrimination based on race, color, creed, religion, sex, sexual orientation, national origin, age, marital status, physical disability, medical condition or veteran status.

Please ANSWER ALL QUESTIONS.

Segura Security Services
A Professional Private Security Firm
Raul J. Segura, CEO/CFO
License # PPO10346
1011 W. McCoy Lane • Santa Maria, CA 93455
Phone: (805) 349-0550 • Toll Free: (800) 233-5333
Fax: (805) 922-7286
E-Mail: Segura@lightspeed.net

First Name
M.I.
Last Name
Address
City
State
Zip Code
Phone
Date
Position Applying For
How long at current address?
Complete Address
How long?
Complete Address
How long?
Complete Address
How long?
Minimum Wage Requirement
Distance and/or Time Willing to Travel
Desired Schedule
Full-Time
Part-Time
How Were You Referred To Segura Security Services?
(i.e. newspaper, friend, Cal jobs, etc.)
Have You Ever Applied To Or Worked For Segura Security Services?
Yes
No
Approximate Applications Date:
Dates Employed:
Position:
Do You Have Any Friends Or Relatives Employed By Segura Security Services?
Yes
No
Provide Name & Relationship:
Drivers License #
State
Exp. Date
Do You Now Hold A California State Guard Card?
Yes
No
Number & Exp. Date
Do You Now Hold A California State Firearm Card?
Yes
No
Number & Exp. Date
Please Provide Any Potential Limitations Regarding Your Method Of Transportation To And From Work:
After Employed, Can You Furnish Documentation Providing Your Legal Right To Remain And Work In The United States?
Yes
No
Based On Your Review Of The Job Description, Can You Perform The Duties Of The Position For Which You Are Applying?
Yes
No
Have You Ever Been Terminated Or Asked To Resign From Any Job?
Yes
No
If Yes, Explain Circumstances:
From
To
Employer
Address
Phone Number
Starting Hourly Rate / Final Hourly Rate
Starting Job Title / Final Job Title
Immediate Supervisor / Title / Phone Number
May we contact for reference? If No, please explain:
Summarize the nature of work performed and job responsibilities:
Reason for leaving:
From
To
Employer
Address
Phone Number
Starting Hourly Rate / Final Hourly Rate
Starting Job Title / Final Job Title
Immediate Supervisor / Title / Phone Number
May we contact for reference? If No, please explain:
Summarize the nature of work performed and job responsibilities:
Reason for leaving:
From
To
Employer
Address
Phone Number
Starting Hourly Rate / Final Hourly Rate
Starting Job Title / Final Job Title
Immediate Supervisor / Title / Phone Number
May we contact for reference? If No, please explain:
Summarize the nature of work performed and job responsibilities:
Reason for leaving:
From
To
Employer
Address
Phone Number
Starting Hourly Rate / Final Hourly Rate
Starting Job Title / Final Job Title
Immediate Supervisor / Title / Phone Number
May we contact for reference? If No, please explain:
Summarize the nature of work performed and job responsibilities:
Reason for leaving:
Personal Computers / Software (List Proficiencies):
Other Skills (i.e. Typing WPM, Multi-Line Switchboard, CPR, EMT, etc.):
Describe Any Previous Job Duties Or Special Training / Skills Relevant To The Job For Which You Are Applying:
Have You Ever Served In The U.S. Military?
Yes
No
Branch Of Service
Number Of Years Served
Can You Submit A Copy Of Your DD214?
Yes
No
Have You Been Covicted Of Any Crime
(Including Military Court Martial)?
Yes
No

If Yes, Please Explain (The existence of a criminal record does not constitute an automatic bar from Segura Security Services. However, please explain the offense for which you have been convicted, so that we may determine if it has a direct impact on the qualifications necessary to perform in the position for which you are applying):

Have You Been Arrested For Any Matters For Which You Are Currently Out On Bail Or On Your Own Recognizance Pending?
Yes
No

If Yes, Please Give The Date(s) And Details (The existence of an arrest record does not constitute an automatic bar from employment with Segura Security Services. However, please explain the offense for which you have been arrested, so we may determine if it has a direct impact on the qualifications necessary to perform in the position for which you are applying):

High School or GED
Address
Curriculum / Major
GPA
Degree / Diploma / Certificate Earned
College / University
Address
Curriculum / Major
GPA
Degree / Diploma / Certificate Earned
Trade / Vocational
Address
Curriculum / Major
GPA
Degree / Diploma / Certificate Earned
Business / Other
Address
Curriculum / Major
GPA
Degree / Diploma / Certificate Earned
List Any Academic Honors Or Special Achievements:
If I am hired, I would like to be considered for:
Full-Time
Part-Time
If I am hired, I am able to start work on the following date:

Monday Hours

Tuesday Hours

Wednesday Hours

Thursday Hours

Friday Hours
Saturday Hours
Sunday Hours

Please explain any circumstances that you would not be able to work if hired:

List All Previous Addresses For The Past 3 Years
If Yes, Complete The Following:

Work History:
Please record your work history for the past 7 years - List your most recent employer first (include any relevant volunteer or unpaid work experience). THIS SECTION MUST BE COMPLETED

Technical Skills
Education
Availability
If I am hired, I will commit to Segura Security Services to be available for shifts or on-call on the following days and hours:
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