Online Application

Name (First/Middle/Last)*

Telephone Number*

Street Address*

Town/City*

State*

Zip Code*

Mailing Address (if different than residence)

Email Address*

Date of Birth*

Are you a citizen of the United States?*

Yes

If you are not a citizen of the United States please provide your alien registration number

Are you a high school graduate?*

Yes

If you are not a high school graduate, do you possess a G.E.D. or equivalent?

Yes

Do you possess a valid driver's license?*

Yes

State

Driver's license number

Are you a defendant in a Final Order For Relief From Abuse?*

Yes

Have you been convicted of any criminal offense? (if yes, please list below)*

Yes

If you have been convicted of a criminal offense please explain the circumstances.

Are you currently certified as a police officer?*

Yes

If yes, in what state are you certified police officer?

If you are a certified police officer, are you full or part time certified?

If you are a certified police officer, are you subject to a Brady or Diglio letter?

Have you ever been terminated from a law enforcement or corrections position?*

Yes

If you have ever been terminated from a law enforcement or corrections position, please explain the circumstances.

What special skills or personality traits do you have that might be considered an asset to this position?

Other information

By checking yes, I certify that the information contained in this application is true and correct. I understand that filing false or misleading information will subject me to disqualification for the position of police officer, or, if hired, may be the basis for termination.*

Yes

Police Officer

Online Application