Name

Present Address (Street, City, Zip)

Email Address

Phone Number

Date of Birth*

Place of Birth

Height

Weight

Have you ever worked for this company?
Yes No

If yes, when?

Do you speak any foreign languages fluently?
Yes No

If yes, which?

*The Age Discrimination Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 65 years of age.

Registered Officer

Alarm System Installer

Private Investigator

Security Consultant

Dog Trainer

Commissioned

Alarm System Monitor

Security Sales

Manager

Security Instructor

Yes No

1.

Are you UNDER 18 years of age?

Yes No

2.

Have you ever been CONVICTED of a felony crime in ANY jurisdiction?

Yes No

3.

Have you been CONVICTED of a misdemeanor crime involving moral turpitude in the last SEVEN (7) years?

Yes No

4.

Have you ever been discharged from a military service under LESS THAN honorable conditions?

Yes No

5.

Are you suffering from habitual drunkenness or from narcotics addiction or dependence?

Yes No

6.

Have you been declared incompetent by any court of law?

Yes No

7.

Have you ever committed any act which would be a violation of the Texas Private Investigators and Private Security Agencies Act or the Board Rules of the Texas Board of Private Investigators and Private Security Agencies?

Yes No

Do you have a valid Texas driver’s license?

Yes No

Do you have a motor vehicle at your disposal on a 24 hour per day basis?

Yes No

Is your home phone (as indicated above) located at your normal place of residence?

Yes No

Do you have an actual Social Security Card issued by the U.S. Government?

Yes No

Do you own a handgun suitable for armed post assignments?

Make

Cal

Yes No

Do you own a shotgun suitable for armed post assignments?  

Make

Cal