Apply Now | Certified Protection Agency

🪪 Personal Information

First Name *

Middle Initial

Last Name *

Email *

Phone Number *

Social Security Number

Date of Birth

Address *

City

State / Zip Code

Desired Position *

Desired Pay ($/hr)

💼 Employment History

Previous Employer #1

Employer Name

Contact Phone

Start Date

End Date

Address

City / State / Zip

Pay Rate

Job Position

Reason for Leaving

Previous Employer #2

Employer Name

Contact Phone

Start Date

End Date

Address

City / State / Zip

Pay Rate

Job Position

Reason for Leaving

How did you hear about CPA?

Do you have any Law Enforcement experience?

Yes No

If Yes, how many years?

Do you have any security experience?

Yes No

If Yes, how many years?

⚙️ Additional Qualifications

Firearm Make

Firearm Model

Caliber

Serial #

Do you currently take illegal drugs?

Yes No

Would you be willing to take a drug test?

Yes No

Shirt Size

Pants Size

Black Boots?

Ballistic Vest?

Special Skills / Abilities

Licenses & Certificates

🎖 Military Experience

Are you or have you been a member of the Armed Forces?

Yes No

Branch

Type of Discharge

Duties / Special Training

🎓 Education

Do you have a High School Diploma?

Yes No

High School Name

City / State / Zip

School Address

Did you attend college?

Yes No

College Name

City / State / Zip

School Address

⚖️ Criminal History

Have you ever been convicted or pled guilty to a Misdemeanor in the past 10 years?

Yes No

Have you ever been convicted or pled guilty to a Felony in the past 10 years?

Yes No

Has your license ever been revoked or suspended?

Yes No

Parking tickets in the past 3 years

Do you have any warrants in this state or any other?

Yes No

👥 References

Reference #1 — Name

Phone Number

Occupation

Relationship

Reference #2 — Name

Phone Number

Occupation

Relationship

Reference #3 — Name

Phone Number

Occupation

Relationship

🚨 Emergency Contact

Full Name *

Phone Number *

Relationship

✍️ Applicant Agreement

This application is active for 45 days from the date of submission. I certify that all statements made in this application are true and complete to the best of my knowledge. I understand that any false statements are grounds for immediate dismissal. Employment requires full compliance with all CPA rules and procedures. This application does not constitute an employment agreement. By submitting, I consent to a background and reference investigation.

Full Name (Electronic Signature) *

Today's Date *

Join the CPA Team

Previous Employer #1

Previous Employer #2

Application Submitted!