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Employment Application

Applicant Information

(including, but not limited to such offenses as DUI, battery, theft, writing worthless checks, etc.)? Conviction means you were found guilty by a judge, a jury, by pleading 'no contest,' or by pleading guilty in court. A conviction may have taken place even if you did not pay a fine or spend any time in jail or prison. A conviction will not automatically disqualify you from employment.


References (Please list three of your direct supervisors)

Previous Employment

Military Service

Disclaimer and Signature

By Clicking the Submit button I Agree to each pargaraph below

1. I hereby authorize State Fire DC Specialties to thoroughly investigate my references, work record and education and any other matter related to my suitability for employment.  I authorize the references I have listed to disclose any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure.  In addition, I hereby release my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

2. I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and State Fire DC Specialties.  In addition, I understand and agree that if I am employed my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or State Fire DC Specialties, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and State Fire DC Specialties’ designated representative.

3. Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by State Fire DC Specialties, I am entitled to copies of any such public records obtained by the Company unless I mark the check box below.  If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.

4. I hereby certify that I have not knowingly withheld any information that might negatively affect my changes for employment and that the answers given by me are true and correct to the best of my knowledge.  I understand that if I have omitted or misstated any material fact on this application or on any document used to secure employment, this shall be grounds to reject this application or to discharge me if I am employed, regardless of the time elapsed before discovery.

5. I certify that I have personally completed this application.