NOTE: Applications are considered for all positions without regard to race, color, religion, sex, national origin, or disability. In compliance with the Immigration Reform and Control Act of 1986, Security America employs only individuals who are authorized to work in the United States.

NOTE: All Highlighted Fields are required.

Last Name First Name Middle Name

Location you are applying for:

Present Address: (Street) (City) (State) (Zip)

Home Phone Cell Phone E-mail Address Are you over 18 years of age Yes No

Position desired: Security Officer Investigator Management Clerical Other

Have you been convicted of a crime except minor traffic violations? Yes No When Offense

Previously employed by Security America? Yes No From To Where

Education Schools Attended Years Completed High School 9 10 11 12 GED College or University 1 2 3 4   Graduate or Other 1 2 3 4

Employment Record *Most recent employer first. **Phone numbers are required Dates Mo./Yr. Position and Name Supervisor Reason for Leaving Employer Phone # ** To Job Title 1. Address City - State - Zip From Supervisor Employer Phone # ** To Job Title 2. Address City - State - Zip From Supervisor Employer Phone # ** To Job Title 3. Address City - State - Zip From Supervisor Employer Phone # ** To Job Title 4. Address City - State - Zip From Supervisor Employer Phone # ** To Job Title 5. Address City - State - Zip From Supervisor

Military: Served in U.S. Armed Forces? Yes No If Yes, Branch: Years of service:

Additional Information:

Do you have your own phone? Yes No

Do you have a weapons permit? Yes No

Will you do strike work? Yes No

Do you have reliable transportation? Yes No

Is there any specific shift that you cannot work? Weekends Days Evenings Holidays Is there any specific shift that you prefer? Days Evenings Midnights Any Is there any specific shift you are applying for? Full Time Part Time Special Needs Temporary Assignment

What are your salary requirements?

How far are your willing to travel to work?

Date you are available to start work?

As a security officer you may be required to walk for long periods, and or stand for long periods of time. Can you meet this requirement? Yes No

If we are unable to contact you between 8am and 5pm, is there an alternative way to reach you? How?

Please list certificates. EMT, First Aid, CPR, etc.

Applicant: Read Carefully Before Submitting I declare that my answers to the questions on this application are true, and give SA the right to investigate all information given, (including previous employers) and to secure additional information, if necessary. I understand that falsification of information on this application may result in my discharge, if hired. If employed, I understand and acknowledge that I am an at-will employee and that nothing verbally stated or written can be construed as a direct or implied contract of employment between SA, Inc. and myself except by way of a specific written employment agreement between myself and SA, Inc. I understand that drug testing is required upon serious consideration for employment. I hereby authorize the release of any information regarding my past job performance and character. Application Date: 08/29/2005