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Police Employment Application
This form has been modified since it was saved. Please review all fields before submitting.
Steps
1.
Step One
This section is complete
This section is incomplete
2.
Step Two
This section is complete
This section is incomplete
3.
Step Three
This section is complete
This section is incomplete
4.
Step Four
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5.
Step Five
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Step One
Position Desired
*
-- Select One --
Police Officer
Dispatcher/Class 2 Officer
On-Call Dispatcher
Date of Application
*
Date of Application
Email address
*
First Name
*
Middle Name
Last Name
*
Phone Number
*
Birth Date
*
Birth Date
Have you ever changed your name?
*
Yes
No
If yes, when?
If yes, when?
List all other names:
Street Number
*
Please provide your current residence.
Street Name
*
Apt #
City
*
State
*
Zip
*
How long at this address?
*
How long a resident of York County?
How long a resident of South Carolina?
Best Time to Call
*
-- Select One --
Between 8 AM and 12 PM
Between 12 PM and 4 PM
Are you willing to relocate?
-- Select One --
Yes
No
Continue
Step Two
Marital Status
*
-- Select One --
Single
Married
Divorced
Widowed
Separated
Spouse's Name
Spouse's Address
Spouse's Place of Employment
Total number of dependents:
*
-- Select One --
0
1
2
3
4
5+
Please list name, age, and relationship of all dependents.
Family Members
Please list all immediate family members and addresses.
Please list all immediate family members and addresses.
Family Member
-- Select One --
Father
Mother
Father-in-Law
Mother-in-Law
Brother
Sister
Other
Deceased?
Yes
No
First Name
Last Name
Address1
City
State
Zip
Family Member
-- Select One --
Father
Mother
Father-in-Law
Mother-in-Law
Brother
Sister
Other
Deceased?
Yes
No
First Name
Last Name
Address1
City
State
Zip
Family Member
-- Select One --
Father
Mother
Father-in-Law
Mother-in-Law
Brother
Sister
Other
Deceased?
Yes
No
First Name
Last Name
Address1
City
State
Zip
Family Member
-- Select One --
Father
Mother
Father-in-Law
Mother-in-Law
Brother
Sister
Other
Deceased?
Yes
No
First Name
Last Name
Address1
City
State
Zip
Family Member
-- Select One --
Father
Mother
Father-in-Law
Mother-in-Law
Brother
Sister
Other
Deceased?
Yes
No
First Name
Last Name
Address1
City
State
Zip
Family Member
-- Select One --
Father
Mother
Father-in-Law
Mother-in-Law
Brother
Sister
Other
Deceased?
Yes
No
First Name
Last Name
Address1
City
State
Zip
Previous Addresses
Please list your previous addresses within the last 5 years if different from current address.
Please list your previous addresses within the last 5 years if different from current address.
Address
City
State
Zip
Address
City
State
Zip
Address
City
State
Zip
Continue
|
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Step Three
Have you applied with the City of Tega Cay Police Department before?
*
-- Select One --
Yes
No
If yes, when?
If yes, when?
Are you a former employee?
*
-- Select One --
Yes
No
Are you eligible to work in this Country? (proof of citizenship or work visa will be required)
*
-- Select One --
Yes
No
Are you available for overtime if required?
*
-- Select One --
Yes
No
Will you submit to a pre-employment physical?
*
-- Select One --
Yes
No
Can you work shift type work?
*
-- Select One --
Yes
No
Are you able to work nights, weekends, and/or holidays?
*
-- Select One --
Yes
No
Have you applied at any other Law Enforcement agency within the last 5 years?
*
-- Select One --
Yes
No
If yes, list the agency name and the application date.
Have you ever been convicted of a criminal offense, including traffic offenses?
*
-- Select One --
Yes
No
Such conviction may be relevant, but does not necessarily bar you from employment.
If yes, please describe:
Include date, place, charge, and final disposition.
Drivers License Number
*
State Issued
*
Has your driver's license ever been suspended?
*
-- Select One --
Yes
No
If yes, when?
If yes, when?
Reason:
Have you had any credit problems in the past five years?
*
-- Select One --
Yes
No
If yes, please explain:
List anyone you know who works for the Tega Cay Police Department:
Do you have any relatives who are employed by the Tega Cay Police Department? If yes, who?
*
Has any member of your immediate family ever been convicted of a felony?
*
-- Select One --
Yes
No
If yes, please include date, place, charge, and final disposition.
Continue
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Step Four
Current or Previous Employer
*
Dates of Employment
*
Dates of Employment Start Date
—
Dates of Employment End Date
Address
City and State
Position(s) worked
*
Reason for Leaving
*
May we contact them?
*
-- Select One --
Yes
No
Phone Number
*
Previous Employer
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Address
City and State
Position(s) worked
Reason for Leaving
May we contact them?
-- Select One --
Yes
No
Phone Number
Previous Employer
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Address
City and State
Position(s) worked
Reason for Leaving
May we contact them?
-- Select One --
Yes
No
Phone Number
Continue
|
Go Back
Step Five
List any special abilities, interests, or hobbies:
List professional, volunteer, trade, business, or civic activities and office held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status.
Have you ever belonged to any group that promotes, urges, or seeks to overthrow the government of the US or State of South Carolina?
*
-- Select One --
Yes
No
If yes, explain.
Training and Certifications
List any training or certifications you may have that may better qualify you for the position you are seeking.
Education
*
List what education levels you have achieved, name of the institution, degree achieved, and year completed (ex. 2003).
References
References
Give three references who are responsible adults of reputable standing.
Give three references who are responsible adults of reputable standing.
First Name
*
Last Name
*
Address1
*
City
*
State
*
Zip
*
Occupation
*
Phone
*
Years Acquainted
*
First Name
*
Last Name
*
Address1
*
City
*
State
*
Zip
*
Occupation
*
Phone
*
Years Acquainted
*
First Name
*
Last Name
*
Address1
*
City
*
State
*
Zip
*
Occupation
*
Phone
*
Years Acquainted
*
Have you ever served on active duty in the Armed Forces of the United States?
*
-- Select One --
Yes
No
Branch of Service
Serial Number
Type and Basis for Discharge from Armed Forces
Please list the information of your discharge from the Armed Forces (type and basis).
Are you now a member of any reserve unit?
Yes
No
Ready
Stand by
Dates in Service
Dates in Service Start Date
—
Dates in Service End Date
If you are in a pay status requiring that you attend drills, meetings, or camps, give name of unit and location:
If you were ever exempt from service in the Armed Forces, state reason:
If you are disabled, and wish to be identified as such, according to the Rehabilitation Act of 1973, please indicate so by checking the box below.
Yes
Other Information
Please list any other information that you think is pertinent to the position applied for.
Upload Resume
It is understood and agreed that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed. Furthermore, I understand that just as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary. I give the Employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the Employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. The Employer is an equal opportunity employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excluding any applicant's consideration for employment on a basis prohibited by local, state or federal law. This application is current for only sixty (60) days. At the conclusion of this time, if I have not heard from the Employer and still wish to be considered for employment, it will necessary for me to fill out a new application.
It is understood and agreed that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed. Furthermore, I understand that just as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary. I give the Employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the Employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. The Employer is an equal opportunity employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excluding any applicant's consideration for employment on a basis prohibited by local, state or federal law. This application is current for only sixty (60) days. At the conclusion of this time, if I have not heard from the Employer and still wish to be considered for employment, it will necessary for me to fill out a new application.
By checking the box below, I certify that all the information provided above is true and accurate to the best of my knowledge.
*
Yes
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