Have you ever been convicted of a crime (felony or misdemeanor) which may preclude your ability to obtain a state license registration card in the alarm industry in which Security Instrument Corp conducts work, (this excludes any records of convictions or arrests that have been sealed, impounded, or expunged.) You may find the requirement for licensure in each of these states on their respective state websites. If yes: please outline conviction/date of occurrence/and explanation.

I consent to any medical examination required by Security Instrument Corp at any time to determine my ability to perform the essential duties of my job or other jobs with Security Instrument Corp and I understand that my employment may be conditioned upon satisfactorily passing a physical examination. I understand that I may be required to satisfactorily complete an alcohol/drug screening as a condition of employment. I may also be subject to polygraph testing and credit checks as applicable by law. I understand that my employment can be terminated at any time and for any reason, at the option of either Security Instrument Corp or myself. I understand that no one has any authority to enter any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except for a written employment agreement signed by the President of Security Instrument Corp. I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete. I understand that any false or misleading representations or omissions may disqualify me from further consideration for employment and may result in discharge even if discovered at a later date. I hereby authorize persons, schools, law enforcement agencies, my current employer (if applicable) and pervious employers and organizations named in this application (and accompanying resume, if any) to provide Security Instrument Corp and all affiliates with any relevant information regarding an employment decision, and I release all such persons from any liability regarding the provision or use of such information. I understand and agree that if hired, I will be requested to provide certain forms of identification to prove eligibility to work in the United States, as well as document for FBI clearance and state police organizations.