Police Department Employment Application

Employment Requirements

Applicant Information

Date / Time

Date

Time

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email

Date of Birth

Driver's License #

Driver's License State

Social Security #

Position Applied For

Are you a citizen of the United States?

Yes
No

If no, are you authorized to work in the US?

Yes
No

Have you ever worked for the City of Girard?

Yes
No

authorized Requirements Relationship

If yes, when?

Yes
No

Have you ever been convicted of a criminal offense other than a minor traffic violation?

Yes
No

If yes, please explain.

Yes
No

Education

High School

High School Name

High School Address

From / To (Years Attended)

Did you graduate?

Yes
No

Diploma Type

College

College Name

College Address

From / To (Years Attended)

Did you graduate?

Yes
No

Degree Earned

Other Education

Other School/Training Name

Address

From / To (Years Attended)

Did you graduate/complete?

Yes
No

Degree/Certificate Earned

References

Please list three references who are not related to you

1.) Name

First

Last

Relationship

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

2.) Name

First

Last

Relationship

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

3.) Name

First

Last

Relationship

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Police Department Employment Application

Employment Requirements

Applicant Information

Education

High School

College

Other Education

References

Application Options

Contact