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Boston General Job Application

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Boston General Job Application Powered By Docstoc
					                                    SOUTH BOS TON POLICE DEPARTMENT
                                                  640 Hamilton Blvd.
                                            South Boston, Virginia 24592
                                   Telephone: (434) 575-4273 . FA X (434) 575-0179

G. M itchell Reed, Colonel                                                  James W. Binner, Captain
Chief of Police                                                             Deputy Chief of Po lice
15 th Session AOMP                                                          212th Session FBI National Academy



APPLICATION FOR EMPLOYMENT

PLEAS E READ B EFORE COMPLETING THIS APPLICATION
The questions asked in this application are necessa
y in order for our depart ment to init iate a thorough investigation. By nature of the position applied for, a security
clearance is vital. All informat ion given by you will only be used to assist in determining your suitability for this
position.

Please
fill in co mpletely and answer all questions correctly. Type or print using BLACK ink, in your own legi ble
handwri ting. A ll applicants shall furn ish the following:


     1.   Copy of your social security card.

     2.   Copy of/or actual birth certificate.

     3.   Cert ified copies of high school transcripts or copy of G.E.D.

     4.   Cert ified copies of college transcripts.

     5.   Copy of military record. (If applicab le)

     6.   Copy of last employ ment evaluation. (If applicable)

     7.   Three (3) letters ** of reference.

          ** The letters should call you by name and mention the position you are applying for.

If space provided is not sufficient for co mplet ing answers, or you wish to furnish additional informat ion, attach
sheets the same size as this application.

After all of these forms have been completely filled out, they must be hand delivered or mailed to South Boston
Police Depart ment, 640 Hamilton Blvd., P. O. Bo x 608, South Boston, Virginia 24592.


Thank you for your attention.

                                                 G. M itchell Reed, Chief of Police
                                                 South Boston Police Depart ment
                                                 640 Hamilton Blvd.
                                                 South Boston, VA 24592
PERSONAL HIS TORY STATEMENT                                                   Item A
FULL NAM E:_________________________________________________________________________

PRESENT ADDRESS: _______________________________________ ZIP CODE:________________

LIST A LL FORM ER ADDRESSES AND DATES THAT YOU RESIDED AT EA CH, START WITH THE FIRST
ADDRESS AND W ORK DOWN TO PRESENT.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

PHONE NUM BER:__________________________ BUSINESS PHONE_________________________

DATE OF BIRTH_________________________ NOTE: The Age Discrimination in Emp loyment Act of 1967 as
amended prohibits discrimination on the basis of age with respect to individuals who are at least 40 bu t less than 70
years of age.

OPERATOR LICENS E

NUM BER OF YEA RS DRIVING EXPERIENCE:_____________________________________________
OPERATOR'S LICENSE NUM BER:________________________________________

HAS YOU
OPERATOR'S OR CHA UFFEUR'S LICENSE EVER BEEN REVOKED OR SUSPENDED LOCA LLY OR OUT
OF STATE?__________________________________________________________

HA VE YOU EVER BEEN INVOLVED IN AN AUTOM OBILE ACCIDENT?______________________

IF YES, EXPLAIN (dates and locations included)_____________________________________________
_____________________________________________________________________________________

POLICE RECORD

HA VE YOU EVER BEEN CONVICTED OF ANY CRIM INA L OR TRAFFIC OFFENSE?___________
IF YES, EXPLAIN:_____________________________________________ ________________________

HA VE YOU EVER BEEN DETAINED OR ARRESTED BY THE POLICE?_______________________
IF YES, EXPLAIN:_____________________________________________________________________

IS THERE ANY COURT A CTION PENDING (CRIMINAL OR TRAFFIC) A GAINST YOU AT THIS TIM E?
_____________________________________________________________________________

IF YES, EXPLAIN:_____________________________________________________________________

HA VE YOU EVER USED OR EXPERIM ENTED WITH ILLEGA L DRUGS?________________ _.
IF YES, EXPLAIN:______________________________________________________________________

______________________________________________________________________________________.
EDUCATION
HIGH SCHOOL NAM E____________________________________________ _____________________

LOCATION:___________________________________________________________________________

DATE GRA DUATED:_______________________________________________________________

G.E.D. CERTIFICATE: _______________ DATE RECEIVED _________________________



COLLEGE
  NAME_______________________________________________________________
  LOCATION________________________________________________________________


   DATE GRA DUATED:____________________ HOURS COMPLETED:_______________________

ARE YOU PRESENTLY ENROLLED IN A NY SCHOOL OR COLLEGE FOR ACADEM IC CLASSES? _____

IF YES, LIST COURSE, NAM E A ND ADDRESS OF SCHOOLS:_______________________________

MILITARY STATUS
IF YOU CA N PROVIDE A COPY OF FORM DD-214, DISREGA RD THE FOLLOWING QUESTIONS IN THIS
SECTION.

BRANCH OF SERVICE:__________________________ DATE OF ENTRY:______________________

PLACE OF ENTRY:___________________________ SERVICE NO.:__________________________

MONTHS OF BASIC TRAINING, AND WHERE:___________________________ _________________

PERMA NENT DUTY STATIONS:
                       (1)_______________________________ HOW LONG?_______________
                       (2)_______________________________ HOW LONG?_______________
   OTHERS:_________________________________________________________________________

PRIMARY DUTIES OF RATE OR RANK: (EXPLAIN)________________________________________
_____________________________________________________________________________________

HIGHEST RA NK OR RATE:__________________ DATE PROM OTED:_________________________

SERVICE SCHOOLS ATTENDED:________________________________________________________

MEDALS OR AWARDS RECEIVED:______________________________________________________

DISCIPLINA RY A CTION, IF A NY (EXPLAIN)____________________________________________
_____________________________________________________________________________________

DATE OF DISCHA RGE OR RELEASE:___________________ TYPE:______________________
TERMINATION DATE OF M ILITA RY RESERVE OBLIGATION, IF ANY: ______________________




ARE YOU NOW A MEM BER OF ANY MILITA RY RESERVE ORGA NIZATION? ________________
IF YES, NAME THE ORGANIZATION AND YOUR STATUS INCLUDING OBLIGATION TIM E, DRILL
STATUS AND COMPULSORY DUTY STATUS.______________________________________

WERE YOU EVER REJECTED FOR M ILITA RY SERVI CE? __________________________________
IF YES, EXPLAIN ON SEPA RATE SHEET OF PA PER.

LOANS OR OB LIGATIONS
HA VE YOU EVER BEEN GA RNISHED, OR CLA IM ED BANKRUPTCY? ________________
IF YES, EXPLAIN:________________________________________________________________


HEALTH                                                                   Item A
WHAT IS THE CURRENT STATUS OF YOUR HEA LTH?____________________________________

HA VE YOU EVER HA D ANY SERIOUS ILLNESS OR HOSPITA LIZED FOR ANY MAJOR
OPERATIONS?___________________
IF YES, EXPLAIN: ____________________________________________________________________

DO YOU W EAR GLASSES? _____________________________________________________________
WHAT IS YOUR RATED VISION WITHOUT GLASSES? ____________________________________

WHAT IS YOUR RATED VISION WITH GLASSES? ________________________________________
DATE OF LAST COMPLETED PHYSICA L EXAMINATION:____________________________

NAME OF EXAMINING DOCTOR:_______________________________________________
ADDRESS
___________________________________________________________________________

FOR W HAT REASON WAS THE EXAMINATION CONDUCTED?_____________________________

NAME AND ADDRESS OF YOUR PHYSICIA N: ____________________________________________

WILL YOU AUTHORIZE THE INVESTIGATION TO EXAMINE ANY A ND ALL M EDICA L RE CORDS
PERTAINING TO YOUR M EDICAL HISTORY? __________________________________

EMPLOYM ENT HISTORY
ARE YOU WILLING FOR US TO ASK YOUR PRESENT EMPLOYER ABOUT YOUR W ORK? _____
HA VE YOU EVER BEEN DISCHA RGED OR
ORCED TO RESIGN BECAUSE OF MISCONDUCT OR UNSATISFACTORY SERVICE?
______________________________________________________
IF YES, EXPLAIN:_____________________________________________________________________

HA VE YOU EVER HA D ANY DISCIPLINARY A CTION TAKEN A GA INST YOU? _______________
IF YES, EXPLAIN: ____________________________________________________________________
List below your co mplete work history, starting with your present and working backward through your experience.
List any periods of unemployment. In all cases, give name of immediate supervisor and home phone number.
----------------------------------------------------------------------------------------------------------------------------- ---
EMPLOYER                         DATES EMPLOYED                                        WORK PERFORM ED
____________________________________From________ To___________________________________
ADDRESS                               TELEPHONE NUMBER                                      SALA RY
____________________________________________________________Starting_______Final________
JOB TITLE                             SUPERVISOR                            TELEPHONE NUMBER
____________________________________________ _________________________________________
REASON FOR LEA VING
_____________________________________________________________________________________
EMPLOYER                                         DATES EM PLOYED                            WORK PERFORM ED
_______
____________________________From________To_________ __________________________
ADDRESS                          TELEPHONE NUMBER                                           SALA RY
_____________________________________________________________Starting_______Final_______
JOB TITLE                  SUPERVISOR                            TELEPHONE NUMBER
_________________________________________________________ ____________________________
REASON FOR LEA VING
_____________________________________________________________________________________

EMPLOYER                                DATES EMPLOYED                       WORK PERFORM ED
____________________________________From_______To____ ________________________________
ADDRESS                    TELEPHONE NUMBER                                  SALA RY
_____________________________________________________________Starting_______Final_______
JOB TITLE             SUPERVISOR                      TELEPHONE NUMBER
___________________________________________________ __________________________________
REASON FOR LEA VING
_____________________________________________________________________________________
 If you need additional space, please continue on a separate sheet of paper.

REFERENCE

REFERENCE; GIVE THE NAM ES AND ADDRESS OF THREE RELIABLE PERSONS, OTHER THAN
RELATIVES OR YOUR PAST EMPLOYERS, WHO KNOW YOU W ELL ENOUGH TO GIVE INFORMATION
ABOUT YOU.

NAME                     PHONE          ADDRESS                  OCCUPATION

______

______________________________________________________________________ _______
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________ _________
ADDITIONAL INFORMATION

HA VE YOU EVER MADE APPLICATION TO A NY OTHER POLICE A GENCY? ________________

IF YES, WHERE_______________________________________________________________________

WHAT WAS THE DISPOSITION MADE OF YOUR APPLICAT ION?
_____________________________________________________________________________________
DO YOU EXPECT TO ENGA GE IN A NY OTHER GAINFUL VOCATION IF YOU ARE SUCCESSFUL IN
GA INING APPOINTM ENT? ____________________________________________

LIST PHYSICA L A CTIVITIES (PAST & PRESENT) IN WHICH YOU PA RTICIPATE:
_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

ARE YOU LEGA LLY ELIGIBLE FOR EMPLOYM ENT IN THE U.S.?         YES_______ NO _______
ORGANIZATIONS: (Any Clubs or Affiliat ion you have)
___________________________________________________________________ __________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________


INTERESTS:

_____________________________________________________________________________________

_____________________________________________________________________________________

PLEAS E S TATE IN YOUR OWN WORDS, WHY YOU WANT TO PURS UE A CAREER IN LAW
ENFORCEMENT.
(US E B LACK INK AND IN YOUR OWN HANDWRITING.)

_______________________________________________________________________________ ______________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
PLEAS E HAVE BOTH NOTORIZED FORMS COMPLET ED B EFORE TURNING IN YOUR
APPLICATION:


I HEREBY CERTIFY THAT THERE ARE NO WILLFUL MISREPRESENTATIONS IN OR FALSIFICATIONS
OF THE ABOVE STATEM ENTS AND ANSW ERS TO QUESTIONS. I AM AWARE THAT SHOULD
INVESTIGATION DISCLOSE SUCH M ISREPRESENTATIONS AND FA LSIFICATION, M Y APPLICATION
WILL BE REJECTED, AND I WILL BE DISQUA LIFIED FROM APPLYING IN THE FUTURE FOR ANY
POSITION IN THE SERVICE FOR THE TOWN OF SOUTH BOSTON P OLICE DEPARTM ENT.

_______________________________________                 ____________________________
SIGNATURE OF APPLICA NT                                 DATE


State of Virg inia, Town/County of_____________________; to wit _________________ has personally appeared
before me, and subscribed and sworn to the accuracy of the foregoing inst rument this _____ day of
________________________, _________.

Notary Public Seal                         ________________________________
                                                  Notary Public




My commis
ion expires:___________________,_________.

NOTE: You may attach additional sheets of paper noting any information you feel maybe pertinent to our
background investigation, which was not covered in the preceding questions.
                                                                Item B
                TOWN OF SOUTH BOS TON POLICE DEPARTMENT JOB DES CRIPTION
                                    JOB TITLE: POLICE OFFICER I

GEN ERAL S TATEMENT OF JOB

Under general supervision performs, general duty law enforcement work to protect lives, property and rights of the
public for the Town Police Depart ment on a rotating shift. Work involves answering comp laint calls and patrolling
the Town in an official vehicle o r on foot to deter crime or apprehend violators or suspects; and investigating and
securing crime scenes. Emp loyee is also responsible for serving legal papers an d testifying in court. Emp loyee
must exercise tact and firmness in frequent public contact. Employee is expected to exercise independent judgment
and initiative in performing assigned tasks. The e mployee is subject to the usual hazards of law enforcement work.
Reports to a Sergeant and/or other superior officers.

                                 SPECIFIC DUTIES AND RESPONS IB ILITIES

ESSENTIA L JOB FUNCTION

Patrols the Town; monitors radio calls; inspects troublesome areas and checks security of business esta blishments;
answers complaint calls and assists in investigating crimes and disturbances; interviews witnesses; gathers evidence;
interrogates suspects and makes arrests; prepares investigative reports.
Investigates accidents; performs first aid; secures and clears accident scenes; directs traffic.

Fingerprints and photographs suspects and crime scenes. Serv ices legal papers such as summons and wa rrants;
explains briefly the meaning of the papers served and makes arrests when necessary.

Appears in court as witness to give testimony; may confer with supervisory personnel for advice in co mplex cases.

Monitors vehicle speeds with radar; conducts criminal and driv ing checks; issues summons or warnings.

Prepares various reports and forms such as case files, offense reports, accident reports, tow sheets and cards,
property vouchers, lab requests, etc.

                                                  ***************

ADDITIONA L JOB FUNCTIONS

Officers assigned as Canine Handler perform the following addit
onal duties:

Responds to calls to crime scenes to initiate s earch with canine fo r suspect who has fled scene, missing children,
etc.; assists in apprehension of suspects located by canine.

Maintains readiness and proficiency of assigned canine, providing total care for canine in own ho me.

Maintains complete canine training records.
Attends and participates in public events with canine to demonstrate team's method, practices and proc edures in
order to cultivate positive public relations.

Assists in training new officers in the field.




                                                        1-5.14
                                                                                                    Item B
May participate in special public informat ion programs such as drug deterrent campaigns, seat belt safety
campaigns, child fingerprinting pro jects, etc.

Maintains police vehicle and equip ment.

Performs other related work as required.

MINIM UM TRAINING AND EXPERIENCE

United States Cit izen
High School Graduate or G.E.D.
At least 21 years of age

SPECIA L REQUIREM ENTS

Not be convicted of a felony or serious misdemeanor.
Pass background investigation including fingerprint inquires to Central Cri minal Records Exchange and the Federal
Bureau of Investigation.
Undergo physical examination subsequent to a conditional offer of employ ment conducted by a licensed physician.
Not produce a positive result on a pre-emp loyment drug screening where the positive result cannot be explained.
Successful comp letion of criminal justice training academy within one year fro m date of h ire.
Must complete 40 hours of in-service training bi-annually. Must possess a valid driver's license.

MINIM UM QUA LIFICATIONS OR STANDARDS REQUIRED TO PERFORM ESSENTIAL JOB FUNCTIONS

Physical Requirements: Must be physically able to operate a variety of machinery and equip ment inclu ding a two-
way radio, typewriter, calculator, copier, etc. Must be physically able to operate a motor v ehicle and operate a
variety of firearms. Must be able to exert up to 150 pounds of force occasionally and/or a neglig ible amount of
force frequently or constantly to lift, carry, push, pull or otherwise move objects. Light work involves sitting most
of the time, but may involve walking, standing, running or physical co nfrontations.

Data Conception: Require the ability to co mpare and/or judge the readily observable, functional, stru ctural, or
compositional characteristics (whether similar to or divergent fro m obvious standards) of data, people or things.

Interpersonal Co mmunications: Requires the ability of speaking and/or signaling people to convey or e xchange
informat ion. Includes giving instructions, assignments and/or directions to subordinates or assistants.

Language Ability: Requires the ability to read a variety of reports, records and memo randums. Requires the ability
to prepare reports, correspondence, forms, etc., using prescribed formats and conforming to all rules of punctuation,
grammar, dict ion, and style. Requires the ability to speak before groups of people with poise, voice control and
confidence.
Intelligence: Requires the ability to learn and understand relatively co mplex princip les and techniques. Requires the
ability to make independent judgments in absence of supervision. Must be able to acquire knowledge of topics
related to primary occupation.




                                                         1-5.15
                                                                                                       Item B
Verbal Aptitude: Requires the ability to record and deliver info rmation, to exp lain procedures, to follow oral and
written instructions. Must be able to communicate effect ively and efficiently in a variety of tec hnical or
professional languages including legal and medical termino logy, and emergency response codes.

Nu merical Aptitude: Requires the ability to utilize mathematical formulas. Must be able to add, subtract, multip ly
and divide. Must be able to utilize decimals and percentages.

Form/Spatial Aptitude: Requires the ability to inspect items for proper length, width and shape.

Motor Coordination: Requires the ability to coordinate hands and eyes rapidly and accurately in using automated
weaponry. Must be able to operate a motor vehicle.

Manual Dexterity: Requires the ability to handle a variety of items, office equip ment, co ntrol knobs, switches,
weapons, etc. Must have high levels of eye/hand/foot coordination.

Color Discrimination: Requires the ability to differentiate between colors and shades of color.

Interpersonal Temperament: Requires the ability to deal with peop le beyond giving and receiving instructions.
Must be adaptable to performing under stress when confronted with emergency situations.

PHYSICA L COMMUNICATION: Requires the ability to talk and/or hear: (talking - exp ressing or e xchanging
ideas by means of spoken words; hearing - perceiving nature of sounds by ear).

PERFORMA NCE INDICATORS

Knowledge of Job : Has general knowledge of modern law enforcement practices, procedures and investigation
techniques. Has general knowledge of local, state and federal laws relat ive to civil and criminal processes. Has
general knowledge of the locations of streets, roads, highways and the geographic and socioeconomic characteristics
of the Town. Has general knowledge of the content and purpose of legal papers and the practices involved in
serving them. Is skilled in the use of firearms and other law enforcement equip ment. Is able to exercise sound
judgment in emergency land routine situations and to adopt quick, effective and reasonable courses of action. Is
able to apply interpretation of laws to specific situations. Is able to prepare clear and concise reports. Is able to
resent court testimony effectively. Is able to exercise tact and firmness in contact with the general public. Is able to
establish and maintain effect ive working relat ionships as necessitated by work assignments.

Quality of Work: Maintains high standards of accuracy in exercising duties and responsibilities. Exercises
immed iate remed ial action to correct any quality deficiencies that occur in areas of responsibility. Maintains high
quality commun ication and interacts with all co-workers and the general public.

Quantity of Work: Maintains effective and efficient output of all duties and responsibilities as described under
"Specific Duties and Responsibilities."
Dependability: Assumes responsibility for doing assigned work and for meeting deadlines. Co mpletes a ssigned
work on or before deadlines in accordance with directives, Town policy, standards and prescribed procedures.
Accepts accountability for meet ing assigned responsibilities in the technical, hu man and co nceptual areas.

Attendance: Attends work regularly and adheres to Town policies and procedures regarding absences and tardiness.
Provides adequate notice to higher management with respect to vacation time and time-o ff requests.




                                                         1-5.16
                                                                                                       Item B
Initiat ive and Enthusiasm: Maintains an enthusiastic, self-reliant and self-starting approach to meet job
responsibilit ies and accountabilities. Strives to anticipate work to be done and initiates proper and accep table
direction for the comp letion of work with a min imu m of supervision and instruction.

Judgment: Exercises analytical judgment in area of responsibility. Identifies problems or situations a s they occur
and specifies decision objectives. Identifies or assists in identifying alternative solutions to problems or situations.
Implements decisions in accordance with prescribed and effective policies and procedures and with a minimu m of
errors. Seeks expert or experienced advice and researches problems, situations and alternatives before exercising
judgment.

Cooperation: Accepts supervisory instruction and direction and strives to meet the goals and objectives of same.
Questions such instruction and direction when clarificat ion of results or consequences are justified i.e., poor
communicat ions, variance with Town policy or procedures, etc.

Relationships with Others: Shares knowledge with supervisor for mutual and Town benefit. Contributes to
maintaining high mo rale among all Town emp loyees. Develops and maintains cooperative and courteous
relationships with department emp loyees, staffers and managers in other departments, to project a good Town
image. Tactfully and effectively handles requests, suggestions and complaints fro m other departments and persons
in order to maintain good will within the To wn. Emphasizes the importance of maintaining a positive image within
the Town. Interacts effectively with fello w emp loyees, Sergeant (Unifo rm D ivision), pro fessionals and the general
public.

Coordination of Work: Plans and organizes daily work routine. Establishes priorities for the complet ion of work in
accordance with sound time -management methodology. Avoids duplication of effort. Estimates expected time of
complet ion of elements of work and establishes a personal schedule accordingly. Attends meetings, planning
sessions and discussions on time. Implements work activ ity in accordance with prio rit ies and estimated schedules.
Maintains a calendar for meetings and deadlines.

Safety and Housekeeping: Adheres to all safety and housekeeping standards established by the Town and various
regulatory agencies. Sees that the standards are not violated. Maintains a clean and orderly work place.
1-5.17

				
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