APi Group, Inc. : Empoyment Opportunities

Please fill out the following form

APPLICATION

Full Name:

Street or P.O. Box:

City:

State: Zip Code:

Phone:

Email Address:

Position Applied for:

Job Type:

Are you at least 18 years of age?: Yes No

Are you legally eligible to work in the United States: Yes No

Have you ever been convicted of a crime other than a misdemeanor?: Yes No

Date of Availability for work:

- - Example: 06-16-2005

Full Time or Part Time:

How did you hear about us?

Salary Requirements

Are you willing to re-locate?

Yes No

Desired Location:
(To select multiple locations, hold the Ctrl key while selecting)

EDUCATION
(Name and Location of School)

High School:

Did you Graduate?

Yes No

College or University:

Did you Graduate?

Yes No Degree:

Advanced Degree :

Did you Graduate?

Yes No Degree:

WORK HISTORY
(begin with most recent position)

Company Name :
Address:
Telephone:
Date Employed (state month and year):	ex: 4/1996 - 2/2002
Name of Supervisor:
Job Title:
Description of duties and responsibilities:
Starting Pay:
Ending Pay:
Reason for leaving:
Are you eligible for rehire with this company?	Yes No

Company Name :
Address:
Telephone:
Date Employed (state month and year):	ex: 4/1996 - 2/2002
Name of Supervisor:
Job Title:
Description of duties and responsibilities:
Starting Pay:
Ending Pay:
Reason for leaving:
Are you eligible for rehire with this company?	Yes No

Company Name :
Address:
Telephone:
Date Employed (state month and year):	ex: 4/1996 - 2/2002
Name of Supervisor:
Job Title:
Description of duties and responsibilities:
Starting Pay:
Ending Pay:
Reason for leaving:
Are you eligible for rehire with this company?	Yes No

Company Name :
Address:
Telephone:
Date Employed (state month and year):	ex: 4/1996 - 2/2002
Name of Supervisor:
Job Title:
Description of duties and responsibilities:
Starting Pay:
Ending Pay:
Reason for leaving:
Are you eligible for rehire with this company?	Yes No

We may contact the employers listed above unless you indicate those you do not want us to contact.
DO NOT CONTACT:
Employer name:	Reason:
Employer name:	Reason:

REFERENCES:
Please indicate business references which APi Group, Inc. may contact:
Name:		Business:
Working Relationship to you:
Phone Number:

Name:		Business:
Working Relationship to you:
Phone Number:

Name:		Business:
Working Relationship to you:
Phone Number:

SPECIAL SKILLS:

Please list the computer software programs you are capable of operating:

Please list any other special skills, training, or experience you would like us to know about:

SIGNATURE:

I certify that answers given herein are true and complete.

I authorize investigation of all statements in this application for employment as may be necessary in arriving at any employment decision. I understand that this application is not and is not intended to be a contract of employment. If employed, I may terminate employment at any time for any reason, and the Company may terminate my employment at any time for any reason.

If employment is obtained and it is discovered that false or misleading information has been given in my application or interview(s), I understand that this may result in discharge.

Signed: Dated: - - Example: 06-16-2005

When finished, click Submit Application.

APi Group, Inc. IS AN EQUAL OPPORTUNITY EMPLOYER