APPLICATION FOR VOLUNTEER IN POLICE
CITY OF CROSSVILLE
TENNESSEE
APPLICATION DATE: _________________________________
BY WHAT METHOD DID YOU HEAR ABOUT THIS VOLUNTEER POSITION?
( ) Newspaper Ad ( ) City Employee ( ) Relative ( ) Other _______
If referred by City of Crossville employee, please list: ______________________________
HAVE YOU EVER BEEN EMPLOYED BY THE CITY? ( )Yes ( ) No
If YES, please indicate position, department and dates of employment:
_________________________________________________________________________
DO YOU HAVE ANY RELATIVES EMPLOYED BY THE CITY? ( )Yes ( ) No
If YES, name and department they are employed in:________________________________
PERSONAL DATA
NAME: ______________________________________________________________________
First Middle Last
ADDRESS: __________________________________________________________________
Street Apt. # City State Zip Code
PHONE NO: (Home) _________________________ (Cell) ______________________
When is the best time to contact you? _______________________________________
DO YOU HAVE A LEGAL RIGHT TO WORK IN THE U.S.? ( ) Yes ( ) No
ARE YOU OVER THE AGE OF 21? ( ) Yes ( ) No
HAVE YOU EVER BEEN CONVICTED OF A FELONY? ( ) Yes ( ) No
(Note: This may be relevant if job-related, but does not bar you from employment)
If YES, please explain:_________________________________________________________
____________________________________________________________________________
DRIVER’S LICENSE NUMBER AND STATE: ____________________ Exp. Date:_________
SOCIAL SECURITY NO. ______________________
APPLICATION FOR VOLUNTEER IN POLICE
CITY OF CROSSVILLE
TENNESSEE
EDUCATION AND TRAINING
HIGH SCHOOL ATTENDED: ______________________________________________
_______________________ Graduate? ( ) Yes ( ) No
City State
COLLEGE ATTENDED: ______________________________________________
________________________ Degree Earned? ( ) Yes ( ) No
City State
Major of study: _________________________________
OTHER Education (Business school, trade school, etc):
______________________________________________
_______________________ Graduate/Degree? ( ) Yes ( ) No
City State
Major of study: __________________________________
OTHER TRAINING RECEIVED: (special courses, work training programs, armed forces training, etc.)
____________________________________________________________________________
____________________________________________________________________________
SPECIAL QUALIFICATION AND SKILLS: (licenses, skills and machines, patents or inventions and
publications)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
WORK EXPERIENCES
Employer: Dates of Employment
:
Position: Supervisor:
Address and Phone No:
Salary History: Start $
End $
Duties/Responsibilities:
Reasons for Leaving:
APPLICATION FOR VOLUNTEER IN POLICE
CITY OF CROSSVILLE
TENNESSEE
WORK EXPERIENCES (cont.)
Employer: Dates of Employment:
Position: Supervisor:
Address and Phone No:
Salary History: Start $
End $
Duties/Responsibilities:
Reasons for Leaving:
Employer: Dates of Employment
:
Position: Supervisor:
Address and Phone No:
Salary History: Start $
End $
Duties/Responsibilities:
Reasons for Leaving:
Employer: Dates of Employment
:
Position: Supervisor:
Address and Phone No:
Salary History: Start $
End $
Duties/Responsibilities:
Reasons for Leaving:
APPLICATION FOR VOLUNTEER IN POLICE
CITY OF CROSSVILLE
TENNESSEE
PERSONAL REFERENCES
Please list three persons, other than relatives or former employers, who have knowledge of your
character and/or abilities.
NAME: ____________________________________ YEARS ASSOCIATED: _____________
ADDRESS: ________________________________ PHONE NO. ______________________
NAME: ____________________________________ YEARS ASSOCIATED: _____________
ADDRESS: ________________________________ PHONE NO. ______________________
NAME: ____________________________________ YEARS ASSOCIATED: _____________
ADDRESS: ________________________________ PHONE NO. ______________________
Based on the JOB DESCRIPTION of the position;
Are you able to perform the essential functions of the volunteer job for which you’ve applied?
NOTE: You may be later asked to demonstrate your ability to perform the essential functions.
( ) Yes ( ) No Initials: _______
**APPLICATION INVALID WITHOUT SIGNATURE**
I hereby affirm that the information provided on this application (and accompanying
resume, if any) is true and complete to the best of my knowledge. I understand that
falsified information or significant omissions may disqualify me and my application from
further consideration for employment and may be considered justification for dismissal if
discovered at a later date.
I authorize persons, schools, my current employer (if applicable), and previous
employers and organizations named in this application (and accompanying resume, if
any) to provide any information orally and/or in writing that may be requested to arrive at
an employment decision and waive any right of privilege, privacy and/or confidentiality I
may have in this information.
_______________________________________________ _______________________
SIGNATURE OF APPLICANT DATE
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