Fillable Police Department Application

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Police Department Application

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Country of origin: US
File type: PDF

U.S.A. forms for City of Bangor

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The City of Bangor is an Equal Opportunity Employer.
Applicants are considered for all positions without regard to race or color, sex, sexual orientation,
physical or mental disability, religion, age, ancestry or national origin
240 Main Street
Bangor, Maine 04401
www.bangormaine.gov
APPLICATION FOR EMPLOYMENT
CITY OF BANGOR, MAINE POLICE DEPARTMENT- APPLICATION FOR EMPLOYMENT
Please ll out all questions. Use fourth page if more space is required for any item.
NAME: _______________________________________________________________________________ DATE: ____________________________
Last First Middle
ADDRESS: ______________________________________________________________________________________________________________
Street City State Zip code
HOME TELEPHONE: _____________________________________________ HOURS YOU MAY BE REACHED: ___________________________
CELL TELEPHONE: ______________________________________________
E-MAIL ADDRESS: ________________________________________________________________________________________________________
PERSONAL
Were you ever convicted by a court of an offense other than a trafc violation? YES NO If yes, give details.
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
Are you age 18 or older? YES NO
Have you ever worked for the City of Bangor? YES NO If yes, what year and department/division did you work?: ________________________
Are you eligible to be lawfully employed in the United States? YES NO
(Proof of citizenship or immigration status will be required upon employment)
Driver’s License? YES NO Class: _________________ Endorsements: _________________
Have you ever committed an illegal or immoral act that would have been unlawful if caught? YES NO
If yes, explain: ____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Have you ever failed a police background investigation in the past? YES NO If yes, When? ____________________________________
To whom did you apply? ____________________________________________________________________________________________________
List any court action to which you have been a party, including divorce: _______________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
List any family members presently employed by the City of Bangor (including spouse, parents, children, siblings, uncles, aunts, nephews,
nieces, and any of the same related as in-laws, step-relations, or half-relations.
NAME: _____________________________________________________ DEPARTMENT: _____________________________________________
MILITARY
Military Record:
Are you a Veteran? YES NO
Honorable Discharge? YES NO
Branch of Service: _______________________________________________________________________________________________________
Dates of Service: ________________________________________________________________________________________________________
If you belong to the reserves, indicate branch or unit: ____________________________________________________________________________
How did you learn of this position?
Advertisement Employment Agency Walk-in Friend/relative
Other: _______________________________________________________________________________________
OTHER
SECOND:
Business Name: ___________________________________ Supervisor’s Name/Title: ____________________________________
Employer’s Address: __________________________________________________________________________________________
Address City State Telephone
Dates of Employment:
From: _________ / ________ To: _________ / __________
Month Year Month Year
Position Title: __________________________________________ Salary ___________________________________________
Duties Performed: ____________________________________________________________________________________________
___________________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Reasons for Leaving: __________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
May we contact?Yes No
List all current and previous jobs and activities including part-time employment. Begin with your present or most recent position.
FIRST or PRESENT:
Business Name:
___________________________________ Supervisor’s Name/Title: ____________________________________
Employer’s Address: __________________________________________________________________________________________
Address City State Telephone
Dates of Employment:
From: _________ / ________ To: _________ / __________
Month Year Month Year
Position Title: __________________________________________ Salary ___________________________________________
Duties Performed: ____________________________________________________________________________________________
___________________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Reasons for Leaving: __________________________________________________________________________________________
___________________________________________________________________________________________________________
May we contact your current employer? Yes No
EMPLOYMENT HISTORY
Continued on next page
Name of High School: ______________________________________________________________________________________________________
Did you Graduate? Yes No
College or University: ______________________________________________________________________________________________________
Major Courses: ____________________________________________
Did you Graduate? Yes No If Yes, with what Degree? ___________________________________________________
Graduate Study, Business, Correspondence or Trade School Courses:
Describe: ________________________________________________________________________________________________________________
Major Courses: ____________________________________________
Did you Graduate? Yes No If yes, with what Degree? ___________________________________________________
Have you passed an Alert Test from MCJA? Yes No If yes, date taken: ________________________________________________
Have you passed the Physical Fitness Test from MCJA? Yes No If yes, date taken: ________________________________________
Have you completed the 100 hour school? Yes No If yes, date taken: ________________________________________________
Are you a MCJA BLETP graduate? Yes No If yes, date taken: ________________________________________________
EDUCATION
DISCLOSURE AGREEMENT
I hereby certify that the f
acts set forth above in my employment application are true and complete to the best of my knowledge.
I authorize the City of Bangor to investigate all information set forth in my application, by contacting my prior employers
and other references set forth above, and by any and all other means authorized or permitted by law. I understand that
if I am hired, omissions or false or misleading statements in this application or interviews will be grounds for immediate
termination of my employment.
________________________________________________________ _____________________________________
DISCLOSURE
ADDITIONAL SPACE
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
HR3PD
REFERENCES
Give names and contact information of three persons thoroughly acquainted with your abilities.
Name Telephone Business/Profession
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
THIRD:
Business Name: ___________________________________ Supervisor’s Name/Title: ____________________________________
Employer’s Address: __________________________________________________________________________________________
Address City State Telephone
Dates of Employment:
From: _________ / ________ To: _________ / __________
Month Year Month Year
Position Title: __________________________________________ Salary ___________________________________________
Duties Performed: ____________________________________________________________________________________________
___________________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Reasons for Leaving: __________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
May we contact?Yes No
EMPLOYMENT HISTORY CONT.
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Police Department Application

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Completed 11 July 2020

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