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Police Department Employment Application

  1. The City of Brookville is an Equal Opportunity Employer, and maintains a policy of Equal Employment Opportunity for all employees and applicants. The City of Brookville does not discriminate in employment or the provision of services on the basis of race, color, religion, gender (sex), national origin and ancestry, age, disability, sex (wages), military status, genetic information, pregnancy, or any other characteristic protected by federal or state law.

    The information provided in this application will be used to determine your suitability to continue in the hiring process with the City of Brookville. Please submit one application per position to the address indicated on the job posting or examination announcement. This application will be considered only if it is submitted in response to a current job opening. If you wish to be considered for future job openings with the City of Brookville, you must fill out another job application in response to that specific job opening. Copies are acceptable. Applications lacking sufficient information will not be processed. Please be sure to complete the entire application and ensure your application is received by the closing date. Also note that, once submitted, this completed form will be subject to all applicable public records laws. If you are selected to continue in the hiring process, you will be required to complete additional forms and provide additional information, in addition to updating any information provided in this application.

  2. All information provided on this application and at any stage of the hiring process must be truthful and complete. Any false statements, material misrepresentations, or deliberate omissions of a fact or facts in this application, or at any stage of the hiring process, shall be considered sufficient cause for refusal to hire and shall be considered sufficient cause, if employed, for termination from employment.

  3. Are you legally eligible to work in the US?

  4. Will you be 21 years of age or older on or prior to appointment?

  5. Employment History

    It is required that you complete all sections of your employment history below, beginning with the most recent employment and working back. If you need additional space to provide complete information, attach a letter-sized sheet (8-½” X 11”) to this application, which should include in the caption the position you are applying for and your name.

  6. Do not use "See Resume" as a substitute for completing your employment history.

  7. May We Contact this Employer?

  8. May We Contact this Employer?

  9. May We Contact this Employer?

  10. May We Contact this Employer?

  11. Education

  12. High School

  13. Did you Graduate?

  14. Check Year Completed

  15. Obtained GED?

  16. College / University / Trade Tech

  17. Check Year Completed

  18. Did You Graduate?

  19. College / University / Trade Tech

  20. Check Year Completed

  21. Did You Graduate?

  22. College / University / Trade Tech

  23. Check Year Completed

  24. Did You Graduate?

  25. Position Related Skills

  26. Certifications, Licenses & Other

  27. General

  28. Commercial Driver's License

  29. CDL A

  30. CDL B

  31. CDL C (Passenter-Bus)

  32. Police Related

  33. Fire Related

  34. Other

    Certifications and/or licenses that you currently hold that you feel are relevant to the position for which you are applying, such as Electrical, HVAC, Plumbing, First Aid, FEMA-NIMS, etc.

  35. Candidate Certification

  36. I certify that I have read, understand, and agree and attest to each of the following statements:

  37. 1. All of the information that I have supplied above in my application are true, accurate, and complete, to the best of my knowledge, and that I have not knowingly withheld any information.

  38. 2. I understand that any false statements, material misrepresentations, or deliberate omissions of a fact or facts in this application, or during the hiring process, shall be considered sufficient cause for refusal to hire.

  39. 3. I understand that any false statements, material misrepresentations, or deliberate omissions of a fact or facts in this application, or during the hiring process, shall be considered sufficient cause if employed, for my termination from employment.

  40. 4. I understand that this application will be considered only if it is submitted in response to a current job opening, and that if I wish to be considered for future job openings with the City, I must fill out another job application and submit it in a timely manner for that(those) specific job opening(s).

  41. 5. I understand that the City of Brookville will make a thorough investigation of my entire work and personal history and may verify all data given in my application for employment, related papers, or oral interviews. I authorize such investigation and the giving and receiving of any information requested by the City of Brookville and I release from liability any person giving or receiving any such information.

  42. 6. I understand that information may be obtained through personal interviews with my neighbors, friends or others with whom I am acquainted. This includes information as to my character, general reputation, personal characteristics and mode of living.

  43. 7. I authorize any physician or hospital to release any information which may be necessary to determine my ability to perform the duties of a job I am being considered for prior to employment or, in the future, during my employment with the City of Brookville.

  44. 8. I understand that although management makes every effort to accommodate individual preferences, business needs may, at times, make the following conditions mandatory: overtime, shift work, or a rotating work schedule other than Monday through Friday. I understand and accept these as conditions of my continuing employment.

  45. 9. I understand that if I am offered employment it will be contingent upon submitting to and passing a post-offer physical examination, which may include drug and alcohol screening, and that if I fail, it will be grounds for the contingent offer being withdrawn.

  46. 10. I understand that information received by the City of Brookville regarding my application for employment is subject to the State of Ohio Public Records Act.

  47. 11. I further understand that this is an application for employment and that no employment contract is being offered.

  48. I have read and understand the above.

  49. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  51. This field is not part of the form submission.