SECURITY INDUSTRIES, INC.

1000 Georgiana Street
Hobart, IN 46342

(800) 854-3667 - Toll-free
(219) 942-9447 - Phone
(219) 942-9448 - Fax

info@siifence.com

NWIBRT Safety Award
CAF Sub-Contractor of the Year Award
BP Safety Award
The TAUC Award
The Walsh Group - Safety Award

We are committed to a policy of Equal Employment Opportunity and will not discriminate on any legally recognized basis, including, but not limited to, race, age, color, religion, sex, marital status, national origin, citizenship, ancestry, physical or mental disability, veteran status, or any other legally protected basis.

I understand I must provide a current (within last 30 days) Motor Vehicle Report if I am called in for an interview. A Motor Vehicle Report can be obtained from local BMV.

Indiana Residents please visit the Indiana Bureau of Motor Vehicles by clicking here.

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Applicant Information
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Have you ever been convicted of a felony? * Yes No

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Previous Employment
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Previous Employment
Company Name
Company Phone
Address
Supervisor
Job Title
Responsibilities
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Reason for Leaving
May we contact your previous supervisor for a reference? Yes No

Disclaimer and Signature

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

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