Police Cadet Application

IMPORTANT:

Please complete this application form only if you meet the requirements of the position as described in the job announcement.
Applications are subject to disqualification if not signed and completed fully.
All information is subject to verification.

PERSONAL INFORMATION
Name*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Secondary Phone*
Age*
Date of Birth*
MM slash DD slash YYYY
Hair Color*
Eye Color*
Gender*
SSN*
Driver's License Number*
Class*
State*
Father's Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Mother's Name*
First Last
Phone
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Guardian's Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Who should be notified in case of emergency?
Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Do not indicate "SEE RESUME." List all jobs in the last five years. Be specific in describing these jobs (paid or volunteer). Be sure to list each change in title or promotion separately. If qualifying experience is part-time or volunteer be sure to list the number of hours per week spent doing the work. You may use additional sheets if necessary. Begin with your present or most recent job and work backwards.
Section Break
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Number of Hours Per Week
Employer
Phone
Title of Position
Supervisor
Duties
Reason for leaving (be specific):
Section Break
From*
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Number of Hours Per Week
Employer
Phone
Title of Position
Supervisor
Duties
Reason for leaving (be specific):
Section Break
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Number of Hours Per Week
Employer
Phone
Title of Position
Supervisor
Duties
Reason for leaving (be specific):
Section Break
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Number of Hours Per Week
Employer
Phone
Title of Position
Supervisor
Duties
Reason for leaving (be specific):

Have you ever been arrested?
- Yes
- No
If yes, when, where, and provide an explanation:
List three (3) personal references:
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Section Break
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Section Break
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
I certify all information shown in this application is true and correct to the best of my knowledge. I agree to be fingerprinted, to submit to a reference and background check, a medical examination, a drug and alcohol screening and upon appointment to furnish such proof of age and citizenship as may be required. I understand and agree that any and all misstatements or omissions of material facts on any of the foregoing documents may herein subject me to disqualification or dismissal.
Signature*
Date
MM slash DD slash YYYY
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