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					Broward County Sheriff's Office
Certified Law Enforcement Deputy Sheriff
Job Opportunity
Salary Range                                                                  $44,743 – $69,910 (PBA/ Pay Grade 15)
Shift                                                Ability to work any shift including nights, weekends and holidays
NATURE OF WORK
CERTIFIED DEPUTY SHERIFF work is law enforcement and public safety work in the protection of life and
property through the enforcement of laws and ordinances in the Broward County Sheriff’s Office. Tasks involve the
intermittent performance of extremely physically demanding work, typically involving some combination of reaching,
bending, stooping, kneeling, crouching, running, climbing, and that may involve the lifting, carrying, pushing, and/or
pulling of extremely heavy objects (150+ pounds). Tasks may involve standing, sitting or walking for long periods of
time.
REQUIREMENTS AND NECESSARY DOCUMENTS
1. Minimum age of 19 years.
2. United States Citizen at time of application (F.S.S.943.13(2)).
3. High school diploma or equivalent. An evaluation of foreign high school diploma may be required.
4. Must not have been convicted of any felony. All candidates must not have been convicted of any perjury or a false
statement charge as an adult. All other arrests and convictions will be reviewed on a case-by-case basis. Must have good
moral character as determined by a background investigation (F.S.S. 943.13).
5. Must successfully pass the SWIMMING and BASIC MOTOR SKILLS (modified physical agility) tests prior to
submitting an application. Results for all required tests must accompany the completed application.
6. FDLE Certification must accompany application.
7. Must possess and maintain throughout employment, a valid Florida driver license without any restrictions affecting
job performance. Driver license must show current address. All candidates must submit with the application, a Certified
Department of Motor Vehicles “entire” driving history for every state in which a driver license was held within the last
7 years. The search date must be within one month of the date the application is received in Human Resources.
8. Must pass swimming and modified physical agility tests prior to submitting an application. Results for both required
tests must accompany the completed application.
9. If ever arrested, candidates must submit an official court disposition with the application. Official court dispositions
can be obtained from the Clerk of the Court in the county in which the incident occurred.
10. If claiming Veteran’s Preference, candidates must provide a DD214 Member 4 form at time of application.
WORK LOCATION                      Any location within the Department of Law Enforcement.
CLOSING DATE                       Friday, December 30, 2011
HOW TO APPLY
You are encouraged to apply on-line at www.sheriff.org. If you do not have access to the Internet, you may visit the
Bureau of Human Resources to submit an on-line application Monday-Friday from 8:00 a.m. until 4:00 p.m. in the Ron
Cochran Public Safety Complex, 2601 West Broward Boulevard, Fort Lauderdale, Florida 33312. Completed on-line
applications must be submitted by midnight on the closing date. Completed paper applications must be received in the
Bureau of Human Resources by 5:00 p.m. on the closing date. A resume may accompany a complete application.
Incomplete applications will not be processed.
Applicants who qualify will be subject to an extensive selection process and screening program, which may include, but
not be limited to evaluation of training and experience; written test; computer based test; interview; polygraph
examination; psychological evaluation; employment record, fingerprint and background check; medical examination;
and drug screen. The expected duration of the selection process varies by position and could last 8 to 10 weeks.
Reapplication will be determined on a case-by-case basis.
BSO is an equal opportunity employer and does not discriminate on the basis of age, citizenship status, color, disability,
marital status, national origin, race, religion, sex, or sexual orientation. Veterans’ preference per Florida law.

Posting Date: 08/01/11
H:\SLASSESS\POSTINGS\POSTINGS.2011\11DLE - Certified Online Application Package.doc
                                BROWARD COUNTY SHERIFF’S OFFICE
                                      CLASS DESCRIPTION

                      CLASSIFICATION TITLE: CERTFIED DEPUTY SHERIFF
                            DEPARTMENT OF LAW ENFORCEMENT


                                GENERAL DESCRIPTION OF DUTIES

This is law enforcement and public safety work in the protection of life and property through the
enforcement of laws and ordinances. Employees in this classification perform work in varied law
enforcement assignments, including but not necessarily limited to, motorized patrol, traffic control and
enforcement, preliminary and follow-up investigation at crime scenes, courthouse and port security,
vessel patrol, scuba diving, K-9 handling, serving writs, other court process actions, and assistance in
public safety education and community service programs. Work involves an element of personal
danger and employees must be able to act without direct supervision and to exercise independent
discretion in addressing emergency situations. Work assignments and instructions are received from an
administrative superior who reviews work methods and results through observation, reports and
conferences. Incumbents perform essential class functions as outlined herein according to functional
area of assignment. Performs related work as directed.

                         SPECIFIC DUTIES AND RESPONSIBILITIES

EXAMPLES OF ESSENTIAL FUNCTIONS

The list of essential functions, as outlined herein, is intended to be representative of the tasks performed
within this classification. It is not necessarily descriptive of any one position in the class. The omission
of an essential function does not preclude management from assigning duties not listed herein if such
functions are a logical assignment to the position.

Performs law enforcement patrol activities including, but not necessarily limited to, teletype checks of
property or person; records checks on firearms, stolen equipment or wanted/stolen vehicles;
assessments of driver's operational capacities; transportation of mental patients, prisoners or suspects;
felony stops; Be On the Look Out (BOLO) reviews; searches for missing, lost or wanted persons;
separation of persons involved in domestic disputes; dwelling, building or grounds inspections; vehicle
pursuits; detainment of suspect vehicle drivers; alarm responses; arrest approach and methods
planning; arrests; searches of persons, places and property; riot control; subdues resisting offenders
using force where appropriate up to and including deadly force.

Performs law enforcement investigations including, but not necessarily limited to, recording
identifying marks on vehicles, firearms and other objects; preparing and distributing BOLO reports of
wanted notices; coordinating activities at accident, crime or investigation scenes; searching buildings
or grounds for suspects; establishing identity of suspects; selecting approach and methods for
conducting searches; collecting and transporting of crime scene evidence or property; protecting or
securing accident, crime or investigation scenes; identifying persons through records, pictures, or
identification media; showing mug shots to witnesses or victims; conducting photo lineups;
researching agency records; checking establishments for wanted or missing persons; gathering
intelligence on known or suspected offenders; conducting interviews; interrogating suspects; recording
sworn statements, formal confessions or depositions; preparing reports or affidavits; presenting
testimony and evidence in both civil and criminal court.
Functions in a public safety capacity including, but not necessarily limited to, moving abused persons
to safe environments; obtaining information on injuries to victims and suspects for reports; conducting
presentation before public groups; assisting and referring mentally ill, indigent and other persons
evidencing need of assistance; physically moving persons, vehicles and other property from unsecured
locations; administering first-aid to injured persons; administering CPR procedures on appropriate
persons; providing security for special functions.

Performs traffic related activities including, but not necessarily limited to, examining abandoned
vehicles; investigating requests for vehicle tows; informing vehicle owners of legal obligations or
procedures regarding vehicle removal; gauging speed of moving vehicles; directing traffic on land or
water; observing traffic for violations; conducting traffic stops; investigating and reporting hazardous
roadway or waterway damage; controlling parking; issuing citations or warnings; advising offenders in
lieu of arrest or citation; rescuing or assisting in rescues of trapped persons; informing persons in
accidents regarding reporting and information exchange procedures; explaining legal obligations to
vehicle operators; conducting accident investigations; administering field checks to drivers suspected
of being under the influence of alcohol or controlled substances.

Performs court process actions, including but not necessarily limited to, serving and accounting for
exparte injunctions, eviction notices, enforceable writs and other process actions within the area of
assignment; reading and comprehension of legal and non-legal documents including the preparation
and processing of such documents as citations, affidavits and warrants.

When applicable to area of assignment, operates a law enforcement vehicle; may be assigned to
operate aircraft; may be assigned to operate marine vessels; may be assigned to mounted unit.

ADDITIONAL FUNCTIONS
While the following tasks are necessary for the work of the unit, they are not an essential part of the
purpose of this position and may also be performed by other unit members.

Performs related duties as directed.

                            MINIMUM TRAINING AND EXPERIENCE

High School diploma; experience in law enforcement, investigations or security work preferred; or an
equivalent combination of training and experience.

                                       SPECIAL REQUIREMENTS

Minimum nineteen (19) years of age at time of appointment; certification from the Florida Department
of Law Enforcement (FDLE), Division of Criminal Justice Standards and Training Commission
(CJSTC); possession and maintenance of a valid Florida driver's license throughout employment
without any restrictions that may affect ability to perform the essential functions of the work as
outlined herein. Depending on functional area of assignment, additional licensure, certification, or
training will apply to meet and maintain compliance with established regulatory standards, e.g.,
(including but not limited to) marine patrol, aviation, mounted unit, SCUBA.
                                  PHYSICAL REQUIREMENTS

Compliance with minimum training and standards of an accredited certification institution as set forth
by the recommended FDLE guidelines and CJSTC. Tasks include a criticality component, in
responding to crime scenes or other critical incidents, whereby incumbents are required to maintain
physical abilities consistent with CJSTC standards in order to perform essential duties as outlined
herein on an as needed basis. Emphasis does not consider percentage (%) of time allocated to
performing essential functions. Rather incumbents maintain CJSTC physical standards in order to
perform essential functions at any point during compensatory time regardless of allocated percentage
(%) of time to any one duty.

Depending on functional area of assignment, the following physical requirements may apply:

Tasks involve the intermittent performance of extremely physically demanding work, typically
involving some combination of reaching, bending, stooping, kneeling, crouching, running, climbing,
and that may involve the dragging, pushing, and/or pulling of extremely heavy objects, such as in the
event of chasing and subduing a suspect resisting arrest.

Tasks may involve standing, sitting or walking for long periods of time. Some tasks are performed
with potential for intermittent exposure to disagreeable elements including, but not limited to, heat,
humidity, inclement weather, loud noise, toxic/chemical agents, electrical currents, pathogens, violent
behavior, weapons, explosives, animals. Tasks include working around moving parts, vehicles,
equipment, carts, and materials handling, where extremely heightened awareness to surroundings and
environment is essential in the preservation of life and property. Tasks may include regular exposure
to traffic conditions, where heightened awareness to surroundings and observance of established safety
precautions is essential in avoidance of injury or accidents. Standard body gear and equipment
applies in the preservation of life and property, as does special equipment based on assignment
including, but not limited to, various types of body armor and safety gear.

Broward Sheriff’s Office is an Equal Opportunity Employer. In compliance with the Americans with
Disabilities Act, Broward Sheriff’s Office will provide reasonable accommodations to qualified
individuals with disabilities and encourages both prospective and current employees to discuss
potential accommodations with the employer.
Broward County Sheriff's Office
Certified Law Enforcement Deputy Sheriff
Selection Process
The following is a summary of the selection process for the position of Deputy Sheriff in the
Department of Law Enforcement. The entire assessment process may be completed in 12 to 16
weeks.

 1. Oral Board          Candidates will participate in a formally structured oral board interview
    Interview           which is administered and evaluated by a panel of Certified Law
                        Enforcement Officers. Appropriate business attire is required. Candidates
                        are evaluated on knowledge, skills, and abilities important to the Deputy
                        Sheriff position, such as, but not limited to: Community Policing,
                        Communication Skills, Tolerance for Stress, Self-Presentation and
                        Judgment/Decisiveness. A candidate who is not successful may reapply
                        six (6) months from the interview date. Oral board scores are valid for
                        one (1) year.

 2. Polygraph           Polygraph examinations are administered after a conditional offer of
    Examination         employment is extended. Exams are conducted and interpreted by
                        experienced polygraphists. Areas of questioning will include, but not be
                        limited to: past criminal activity, completeness and truthfulness of all
                        statements made during the selection process, and any past or present use
                        of drugs. The Polygraph reports are valid for one (1) year.

 3. Psychological       Pre-employment psychological evaluations are conducted by experienced,
    Evaluation          licensed psychologists contracted by BSO for this purpose. Only under
                        certain circumstances, will candidates who are not successful be allowed
                        to re-apply for a certified position one (1) year after the date of the
                        evaluation.

 4. Medical             Prior to a final job offer, all candidates are required to successfully
    Examination         complete a job-related medical examination. Exams are performed by a
                        licensed physician. A drug screen is part of this examination.

 5. Background          Background investigations are conducted on eligible candidates.
    Investigation       Investigations will include verification of an applicant’s qualifying
                        credentials to include: educational requirements, employment history,
                        residence and neighborhood checks, citizenship, review of criminal
                        history, driver license history, personal and neighbor references, credit
                        history and military service, if applicable.

 6. Final File Review   The final file review is conducted by the hiring administration. An
                        applicant's file is reviewed in totality and in a competitive manner.
                        Determination for placement of the best-qualified candidates is made
                        among eligible candidates.
                     BROWARD COLLEGE

           CRIMINAL JUSTICE TESTING CENTER
           AT THE INSTITUTE OF PUBLIC SAFETY

                   3501 Davie Road, Building 21

                       Davie, Florida 33314




                                                                Criminal Justice
                                                                Testing Center
                                                                  Building 21




    Testing Center Telephone Numbers and Hours of Operation

       Information Desk: (954) 201 – 6790 or (954) 201 – 6931

               Monday – Friday: 8:00 AM – 4:00 PM
 
                                      GENERAL INFORMATION:

The Criminal Justice Testing Center is NOT a hiring agency; it is a testing center for persons wanting
to enter law enforcement positions in Broward County. The Criminal Justice Testing Center
administers the CRIMINAL JUSTICE BASIC ABILITIES TEST (C.J.B.A.T.), TESTS OF
ADULT BASIC EDUCATION (T.A.B.E.), BASIC MOTOR SKILLS TEST (AGILITY), and the
SWIM TEST to candidates for employment in cooperation with the Broward County Chiefs of Police
Association. Successful completion of specified tests is required for eligibility for consideration of
further evaluation by participating agencies. Verify with the hiring agency as to which test and score
is necessary for consideration.

                                               TO REGISTER

1. Appointments are not necessary for registration.
2. Applicants must personally appear in the lobby at the Institute of Public Safety, Building 21, from
   8:00 AM to 3:00 PM on Tuesday, Wednesday, Thursday or Friday.
3. Complete the “Registration Form” located on page 17 of this booklet.
4. Present a valid photo I.D. Acceptable identification:
      – Valid driver’s license
      – State-issued photo ID
      – United States passport
5. Pay appropriate fees (cash or money order only). Fees are non-refundable.
6. Receive a registration receipt which must be presented for entry to any of the test sites. (Receipt is
   non-transferable)

                                             TESTING PROCEDURES

1. Picture I.D. accepted:
        – Valid driver’s license
        – State-issued photo ID
        – United States passport
2. Registration receipt required.
3. No late entry (must make another appointment).
4. All testing materials provided by the Testing Center
5. Swim and basic motor skills (agility) tests:
        – Form 75B required.
        – Wear athletic shoes, a short-sleeved t-shirt, and track pants or shorts during agility testing
             and practice sessions.
        – The swim test is conducted at the BC Aquatic Complex, located on the west side of the
             campus off of College Avenue, near Building 10.
        – Applicants for the swim test must arrive by 7:30 AM and present a photo I.D. and a paid
             registration receipt.
        – Required swim attire is a short-sleeved t-shirt (not a tank-top) and long pants. Applicants
             must provide their own towels.
        – The swim test requires swimming 50 yards in any stroke style, except back stroke, within
             a 2-minute time-frame.

     YOU MAY NOT ENTER THE TESTING AREA WITH ANYTHING EXCEPT A PICTURE I.D., TEST
         RECEIPT, WALLET AND CAR KEYS. (Purses, bags, brief cases or other containers, personal
      calculators, pens, pencils, papers, books, pagers or cell phones are not permitted and strictly enforced.
                                 TESTING INFORMATION & SCHEDULE

                     TEST                             DAY        TIME        FEE        VALIDITY
      Basic Motor Skills Test (Agility)* **        MONDAY       8:30AM      $20.00     Six (6) months
           Basic Motor Skills Test                THURSDAY 8:30AM           $20.00     Six (6) months
                (Agility)* **
 Basic Motor Skills Test (Agility) Practice* **   THURSDAY 3:30PM             No       Six (6) months
        Registered applicants only                                          Charge
               Swim* ** ***                        MONDAY       7:30AM      $15.00     No expiration

*CJSTC FORM 75B required
**Weather permitting
***Sign in at the pool which is located next to building #10

                                              RETEST RULES

   BASIC MOTOR SKILLS (AGILITY)
     You may pay retest fees and retake this test an unlimited number of times until you pass.
     However, you must meet the one year physical examination criteria.

   SWIM TEST
     You may pay retest fees and retake this test an unlimited number of times until you pass.
     However, you must meet the one year physical examination criteria.

                                              TEST RESULTS

Following your written examinations, you can obtain your test results by signing into the website at
www.broward.edu/ips and click on Log-In, enter your ID number or Social Security number and your
PIN number.
                                   LOCAL PHYSICIAN INFORMATION
      
NOTICE TO APPLICANTS:

If you do not have your own qualifying physician – Medical Doctor (M.D.) or Doctor of Osteopathy
(D.O.) – licensed in the State of Florida, you may choose to contact one of the physicians listed on this
page.

     1. Call physician’s office for information.
     2. When making an appointment, inform the physician that you are an applicant from Broward
        College, Criminal Justice Testing Center.
     3. Request physician to complete and sign the “FORM 75B.” (“Form 75B” remains valid for a
        period of one year and requires that the agility test or subsequent retests occur within that one
        year period)
      
         Karl S. Brot, M.D.                Nancy Cardenas-Bada, M.D.
         1749 NE 26th St.                  Jerome H. Levinson, M.D.
         Wilton Manors, FL 33305           7401 N. University Dr. #103
         (954) 565-3838                    Tamarac, FL 33321
                                           (954) 721-2444
         Peter Simek, MD                   Robert Tomchik, MD
         100 NW 82nd Ave. #206             18475 Miramar Parkway
         Plantation, FL 33324              Miramar, FL 33025
         (954) 424-7504                    (954) 450-3550
         Ali R. Zargaran, M.D.
         2701 E. Atlantic Blvd.
         Pompano Beach, FL 33062
         (954) 942-8987

                                    CERTIFIED DRIVING HISTORY

A Certified Driving History can be obtained the same day at the following local courthouse locations
between the hours of 8:00 a.m. and 4:30 p.m. The fee is $16.25 for a “complete” driving history. For
additional information, contact (954) 831-6565.

NORTH REGIONAL COURTHOUSE
1600 W. Hillsboro Blvd.
Deerfield Beach, Florida 33442

WEST REGIONAL COURTHOUSE
100 North Pine Island Road
Plantation, Florida 33324

BROWARD COUNTY COURTHOUSE
201 S.E. 6TH Street
Fort Lauderdale, Florida 33301

SOUTH REGIONAL COURTHOUSE
3550 Hollywood Blvd.
Hollywood, Florida 33021

PLEASE NOTE:
Three (3) year, seven (7), and electronic (on-line) driving histories WILL NOT be accepted. You must
request a “complete” driving history.
Broward County Sheriff’s Office
2601 West Broward Boulevard
Fort Lauderdale, Florida 33312
(954) 321-4400




Dear Applicant,

The status of your credit is an important part of our hiring process. Debts that have been turned over to a
collections agency or have become public record must be resolved before we can accept your
completed application. A public record is any information contained in a state or county court record,
such as a bankruptcy, tax lien, monetary judgment or in some cases, accounts that are sent to collections.

We recommend you request a copy of your credit report and review it to determine if you have public
record debts. If it is determined that you have public record debts, you will be required to provide
evidence of your debt resolution. Please refer to the information below for guidance.

        The three nationwide consumer reporting companies have set up a central website and a toll-free
        telephone number through which you can order your free annual report. To order, visit
        www.annualcreditreport.com or call 1-877-322-8228. Do not contact the three nationwide
        consumer reporting companies individually. They are providing free annual credit reports only
        through www.annualcreditreport.com and 1-877-322-8228. You may order your reports from each
        of the three nationwide consumer reporting companies at the same time, or you can order your
        report from each of the companies one at a time. The law allows you to order one free copy of your
        report from each of the nationwide consumer reporting companies every 12 months. Please visit
        www.ftc.gov/bcp/conline/pubs/credit/freereports.htm for more information.



In order to resolve your debt, it is recommended that you contact one of the many organizations that can
assist you in resolving your credit issues. An example of a non-profit organization is the Consumer
Credit Counseling Service (CCCS). To receive free, confidential counseling, call their 24-hour hotline at
1-800-355-2227 to make an appointment.


Thank you for your interest in employment opportunities at BSO and we look forward to hearing from
you.

Sincerely,
Selection and Assessment Section
Human Resources Bureau
                                                                                                                                                                  *APP*
                                                       Broward Sheriff’s Office
                                                       APPLICATION FOR EMPLOYMENT
                                                 Broward Sheriff’s Office
                                                 Bureau of Human Resources                                  INSTRUCTIONS
                                                 2601 West Broward Boulevard                                PLEASE USE BLACK INK AND PRINT CLEARLY OR TYPE.
                                                 Fort Lauderdale, Florida 33312                             DO NOT leave any areas blank. Resumes may NOT SUBSTITUTE for any
                                                       Human Resources 954-321-4400                         information requested on this application. INCOMPLETE APPLICATIONS
                                                       Jobline: 888-276-7827
                                                       TDD Line: 954-831-8948                               WILL NOT BE PROCESSED.
                                                       Online: www.sheriff.org

The Broward Sheriff’s Office is an equal opportunity employer and does not discriminate on the basis of age, citizenship, color, disability, marital status, national origin, race, religion, sex, or
sexual orientation. These factors are NOT used as selection criteria, except in rare instances where such factors are bona fide occupational qualifications. This information may be used,
however, for identification purposes in conducting a background investigation.
In accordance with the “Americans with Disabilities Act of 1990”, the Broward Sheriff’s Office will reasonably accommodate qualified individuals with a disability. The reasonable accommodation
requirement applies to the application process, any pre-employment test, interview, and actual employment. If you are disabled and require accommodation, you may request it and the Broward
Sheriff’s Office will make every reasonable endeavor to provide it to you. However, some types of accommodations may require some preparation before they can be provided. Therefore, we
suggest that you make such requests in writing as early as possible by contacting the Human Resources Bureau.


_________________________________________________________________________________________________________________________________________________________
Position You Are Applying For                                                       Date Of Application


_________________________________________________________________________________________________________________________________________________________
Employee Who Referred You                                                           Referring Employee’s CCN
If this position is available in part-time hours, would you be interested?                          YES          NO
To Be Completed By All Applicants                                                                                                                                                         SECTION I
Personal Information:


__________________________________________
Social Security Number


_________________________________________________________________________________________________________________________________________________________
Last Name                                                      First Name                                     Middle Name


_________________________________________________________________________________________________________________________________________________________
Residence Address (No PO Box)                                                                Apt.


_________________________________________________________________________________________________________________________________________________________
City                                          State            Zip Code                      E-Mail Address


_________________________________________________________________________________________________________________________________________________________
Home Phone                            Work Phone                      Extension                     Cell Phone/Other
U.S. Citizen:          By Birth        Naturalized     If not a citizen, are you legally authorized to work in the U.S.?                       YES           NO
Have you EVER applied for employment with the Broward Sheriff’s Office?                                 YES           NO
Are you currently an employee of the Broward Sheriff’s Office?                            YES          NO      CCN _______________Classification______________________________________
Do you wish to claim Veterans’ Preference per Florida Statute?                            YES          NO      If YES, please complete the Veterans’ Preference Claim Form (page 4) and provide a
                                                                                                               copy of your DD-214 Member 4 form with your application.
Have you ever used any other name?                     YES           NO        If YES, please list those names here:


_________________________________________________________________________________________________________________________________________________________
Last Name                            First Name                           Middle Name               From (mm/yy)        To (mm/yy)


_________________________________________________________________________________________________________________________________________________________
Reason


_________________________________________________________________________________________________________________________________________________________
Last Name                            First Name                           Middle Name               From (mm/yy)        To (mm/yy)


_________________________________________________________________________________________________________________________________________________________
Reason

By signing this document, I certify that all of the information on this entire application is true and complete to the best of my knowledge. I
understand that all information is subject to investigation and that omission, falsification, or misrepresentation is sufficient cause for rejection
of this application, removal of my name from consideration, or dismissal from service.


______________________________________________________________________________________________________________________________________________________________
Signature                                                                                                        Date


For Office Use Only:
                                                                                                                                                                                        1
CS: ____________Code: __________
EDUCATION/TRAINING                                                                                                           SECTION I
Are you a high school graduate?         YES       NO      GED

_____________________________________________________________________________________________________________________________________________
High School Name                                                                City                                     State
Colleges/Universities Attended         Check here if not applicable

        College/University                                                                   City                               State

               To (mm/yy)                                                                    Total Credit Hours__________     Semester
                                                                                                                               Quarter
            From (mm/yy)

   Type of Degree Earned

   Date of Degree (mm/yy)                                                                    Field of Study


       College/University                                                                    City                              State

              To (mm/yy)                                                                     Total Credit Hours__________      Semester
                                                                                                                               Quarter
           From (mm/yy)

   Type of Degree Earned

  Date of Degree (mm/yy)                                                                     Field of Study


       College/University                                                                    City                             State

              To (mm/yy)                                                                     Total Credit Hours__________      Semester
                                                                                                                               Quarter
           From (mm/yy)

   Type of Degree Earned

  Date of Degree (mm/yy)                                                                     Field of Study

Academy, Business, Trade or Other Schools Attended          Check here if not applicable

  Academy/School Name                                                                        City                             State

              To (mm/yy)                                                                     Total Credit Hours__________      Semester
                                                                                                                               Quarter
           From (mm/yy)

      Type of Certificate
     Date of Certification/
     Graduation (mm/yy)                                                                      Field of Study


  Academy/School Name                                                                         City                             State

              To (mm/yy)                                                                      Total Credit Hours__________     Semester
                                                                                                                               Quarter
           From (mm/yy)

      Type of Certificate
     Date of Certification/
     Graduation (mm/yy)                                                                       Field of Study

Current Professional Licenses or Certifications         Check here if not applicable
        Type of License/
            Certification                                                                     State

     Date Issued (mm/yy)

                Expiration                                                                    Issuing Agency

         Type of License/
             Certification                                                                    State

     Date Issued (mm/yy)

                Expiration                                                                    Issuing Agency


                                                                                                                                                2
RELATED EMPLOYMENT HISTORY                                                                                                                              SECTION I
LIST ALL FULL-TIME AND PART-TIME work experience which you feel relates to the position for which you are applying. Start with the most recent related position.
Major changes in duties or job titles with the same employer should be listed as separate positions. Describe the job duties in detail to demonstrate that you meet the minimum
requirements of the position that you are applying for. If you need additional space, please photocopy this form and provide all information.


                 Employer

                   Position                                                                                           Total Hours Per Week _________              Full Time

               To (mm/yy)                                                                                                                                         Part Time

             From (mm/yy)                                                                                             Current Salary $



       Detailed Job Duties


                 Employer

                   Position                                                                                           Total Hours Per Week _________              Full Time

               To (mm/yy)                                                                                                                                         Part Time

             From (mm/yy)


       Detailed Job Duties


                 Employer

                   Position                                                                                           Total Hours Per Week _________              Full Time

               To (mm/yy)                                                                                                                                         Part Time

             From (mm/yy)


       Detailed Job Duties


                 Employer

                   Position                                                                                           Total Hours Per Week _________              Full Time

               To (mm/yy)                                                                                                                                         Part Time

             From (mm/yy)


       Detailed Job Duties


                 Employer

                   Position                                                                                           Total Hours Per Week _________              Full Time

               To (mm/yy)                                                                                                                                         Part Time

             From (mm/yy)


       Detailed Job Duties


                 Employer

                   Position                                                                                           Total Hours Per Week _________              Full Time

               To (mm/yy)                                                                                                                                         Part Time

             From (mm/yy)


       Detailed Job Duties
                                                                                                                                                                                  3
VETERANS’ PREFERENCE CLAIM                                                                                                                                                        SECTION I

  Per Florida Statute Chapter 295 and Rules of the Florida Department of Veterans’ Affairs, Veterans’ Preference points shall be awarded to the earned
  ratings of eligible applicants who have achieved a minimum qualifying score on an examination. Special consideration will be given to eligible applicants who
  apply for positions where examinations are not used.

  SUMMARY OF CHANGES EFFECTIVE JULY 1, 2007:
     1.  Preference eligibility no longer expires upon appointment of the eligible person to a position with the state or any political
         subdivision in the state.
     2.  Persons who were previously ineligible for preference because they held or are currently holding a job with a public employer
         are now eligible to use their Veterans’ Preference again with all employers covered by law.
     3.  Persons who were previously ineligible for preference because they did not serve during an eligible wartime period may now
         be eligible for Veterans’ Preference if they served during Operation Enduring Freedom (beginning October 7, 2001 – present)
         or Operation Iraqi Freedom (beginning March 2003 – present). The receipt of a campaign or expeditionary medal is not
         required, only service during those wartime periods.

  In order to receive preference, an applicant must complete the following requirements by the closing date of the employment opportunity specified on the
  posting:

      •       Indicate claim for Veterans’ Preference on this application.

      •       Answer all questions below.

      •       Provide a copy of DD-214 Member 4 Form.




1. Do you wish to claim Veterans’ Preference under Florida Statute Chapter 295?

          YES                       NO


2. Are you:

          A       A veteran of any war who has served on active duty for one (1) day or more during a wartime period, excluding active duty for training, and who was
                  discharged under honorable conditions from the Armed Forces of the United States of America?
          B       A disabled veteran who has served on active duty in any branch of the Armed Forces of the United States of America who has a presently existing
                  service-connected disability compensable under public laws administered by the V.A.?
          C       A disabled veteran who has served on active duty in any branch of the Armed Forces of the United States of America, who is receiving compensation,
                  disability retirement benefits, or pension by reason of public laws administered by the V.A. and the Department of Defense?
          D       The spouse of any person, who has a total and permanent service-connected disability and who, because of this disability, cannot qualify for
                  employment?
          E       The spouse of any person who is missing in action, captured in the line of duty by a hostile force, or forcibly detained or interned in the line of duty by a
                  foreign government or power?
          F       An unremarried widow/widower of a veteran who died of a service-connected disability?



3.   If you have a service-connected disability, such disability has been rated by the V.A. or Department of Defense to be ______________ percent.

A Veterans’ Preference-eligible applicant has a right to an investigation by the Florida Department of Veterans’ Affairs if a non-preference-eligible applicant is selected to the position for which he or
she applies, meets the minimum requirements, and achieves a minimum qualifying score. In order for an investigation to be considered, a request must be filed within twenty-one (21) calendar days
of the applicant receiving notice of the hiring decision by the Broward Sheriff’s Office. Such requests should be made with the Florida Department of Veterans’ Affairs Division of Benefits and
Assistance, PO Box 31003, St. Petersburg, FL 33731; Contact Name: John Burns (727) 319-7462. Any other inquiries regarding Veterans’ Preference should also be sent to this address. You may
also visit the Florida Department of Veterans’ Affairs website at www.floridavets.org.


------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

You may be eligible to benefit under the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended. Submission of this information is voluntary and
refusal to provide it will not subject you to any adverse treatment. If you are an individual with a disability or a covered veteran, we would like to include you under
the affirmative action program. It would assist us if you provide the information below:



                                 Veteran Status:                                          Vietnam era veteran

                                                                                         Other protected veteran (served on active duty during a war or in a
                                                                                         campaign or expedition for which a campaign badge has been authorized,
                                                                                         under laws administered by the Department of Defense)

                                                                                          Recently separated veteran (discharged or released from active duty less
                                                                                          than one year ago)


                                 Disability Status:                                       Individual with a disability




                                                                                                                                                                                                                     4
  CONTROLLED SUBSTANCES                                                                                                                                 SECTION I
  Current employees of the Broward Sheriff’s Office are not required to complete this page.
  •      Do you NOW, or have you EVER tried any illegal drugs or controlled substances? (“Tried” includes smoking; inhaling; swallowing;
         placing/rubbing on gums, lips, or tongue; injecting; or ingesting by any other means.)   YES        NO
          Please be advised that if you are extended a conditional offer of employment, you will be required to provide information regarding frequency of
          controlled substance use.

  •       Do you NOW, or have you EVER purchased or sold any illegal drugs or controlled substances?         YES           NO

  •       Have you ever used marijuana?         YES           NO
          If yes, when was the last time you used marijuana? _________________________________________

  •       Have you ever used cocaine?         YES           NO
          If yes, when was the last time you used cocaine? ___________________________________________

  •       Have you ever used anabolic steroids?       YES          NO
          If yes, when was the last time that you used anabolic steroids? ________________________________

  •      Have you ever used any other controlled substance not listed above, such as ecstasy, mushrooms, acid, oxycontin, or heroin?        YES          NO
         If yes, please specify drugs below:

         NAME OF DRUG:                                                                                             LAST TIME USED:




  CRIMINAL HISTORY                                                                                                                                     SECTION I
                                                                                          Have you EVER been arrested or detained by ANY law
  CHARGES When applying for a position with a law enforcement agency,
  ALL arrests and charges must be disclosed, regardless of the disposition.               enforcement agency for ANY reason? This includes arrests or
  These include, but are not limited to, all charges that have been                       detentions [held for questioning, Notice to Appear or Promise to Appear] as
  dismissed/no action; found not guilty; sealed, expunged and/or purged;                  a juvenile or for violations which were not prosecuted or where some type of
  “Withheld Adjudications”; and Juvenile charges.                                         pre-trial intervention was offered, and includes all arrests regardless of your
                                                                                          plea.
                                                                                                                                YES          NO


                                                                                          Have you EVER been convicted of, or have you EVER been found to
  CONVICTIONS The circumstances surrounding the conviction are                            have committed any civil or criminal law violation other than minor
  considered, such as: the nature, number, severity, date of the offense,                 traffic violations?
  subsequent history, efforts at rehabilitation, and relation of the offense to the                                             YES          NO
  requirements of the position for which you are applying. Most convictions are
  not an automatic disqualification for employment.
                                                                                          Have you EVER had a criminal charge or record sealed, expunged or
                                                                                          purged?
                                                                                                                              YES            NO

If YES, please LIST ALL CRIMINAL AND CIVIL LAW VIOLATIONS. Copies of all court dispositions must be submitted with application. Be sure to include charges
from all states, regardless of the outcome or timeframe. Attach additional pages if necessary.


        Charge, Violation, or                                                                            Date (mm/dd/yy)
             Circumstances

      Location (City & State)


 Detention, Disposition, or                                                                              Date (mm/dd/yy)
                  Penalty

              Please explain
                  disposition


        Charge, Violation, or                                                                            Date (mm/dd/yy)
             Circumstances

      Location (City & State)


 Detention, Disposition, or                                                                              Date (mm/dd/yy)
                  Penalty

              Please explain
                  disposition

                                                                                                                                                                       5
Please use this page to provide any additional information that does not fit in other sections of the application.




                                                                                                                     6
   EQUAL EMPLOYMENT OPPORTUNITY AND RECRUITING SURVEY                                                                                                       SECTION I
   The information requested in this survey will be used to comply with federal equal opportunity requirements and is neither a part of your application
   nor has any bearing on your consideration for employment. This section will be removed by the Bureau of Human Resources.
   ______________________________________________                    __________________________________
  Today’s Date (mm/dd/yy)                                            Date of Birth (mm/dd/yy)                                Sex:        Male        Female


  ______________________________________________                     ________________________________________________________________________________________________
   Position Applied For                                              Other Languages Spoken



                                                                                                                Description of EEOC Race/Ethnic Categories:

                                                                                                                 All persons of Mexican, Puerto Rican, Cuban, Central or South
  Race/Ethnic Category                                                                     Hispanic or Latino
                                                                                                                 American, or other Spanish culture or origin, regardless of race.
  (Check only 1 category. Refer to the chart for descriptions.)
                                                                                                 White           All persons having origins in any of the original peoples of Europe,
     Hispanic or Latino                                                                                          North Africa or the Middle East.

     White (Not Hispanic or Latino)                                                              Black or        All persons having origins in any of the Black racial groups of
                                                                                            African American     Africa.
     Black or African American (Not Hispanic or Latino)                                    Native Hawaiian or
                                                                                                                 All persons having origins in any of the peoples of Hawaii, Guam,
                                                                                             Other Pacific
                                                                                                                 Samoa, or other Pacific Islands.
     Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)                         Islander
                                                                                                                 All persons having origins in any of the original peoples of the Far
     Asian (Not Hispanic or Latino)                                                                              East, Southeast Asia, or the Indian Subcontinent, including, for
                                                                                                 Asian
                                                                                                                 example, Cambodia, China, India, Japan, Korea, Malaysia,
      American Indian or Alaska Native (Not Hispanic or Latino)                                                  Pakistan, the Philippine Islands, Thailand, and Vietnam.
                                                                                           American Indian or    All persons having origins in any of the original peoples of North
      Two or More Races (Not Hispanic or Latino)                                             Alaska Native       and South America (including Central America) and who maintain a
                                                                                                                 tribal affiliation or community attachment.
                                                                                                                 All persons who identify with more than one of the above five
                                                                                           Two or More Races
                                                                                                                 races.




Please take the time to complete the section below. Your response is valuable and will be used for research purposes to better determine where our
recruitment efforts are successful.

How did you FIRST learn of this position? (Check only one)

        Referred by BSO employee                                                                                               Other:

  Name: _____________________________________                                                                                        Applicant is a BSO employee

  CCN: ______________________________________                                                                                        BCC Testing Center

  Work Location: ______________________________                                                                                      BSO Bulletin Board

                                                                                                                                     BSO Mailing/Letter

  Newspaper/Publication:                                          Internet:                                                          Job Fair

        Sun-Sentinel                                                      Sheriff.org                                                Internship Program

        Miami Herald                                                      Jobing.com                                                 Job Line

        Palm Beach Post                                                   Google.com                                                 Military Recruitment

        Brochure                                                          Careerbuilder.com                                          Neighborhood/Community Meeting

        Employment Guide – Atlanta                                        Yahoo.com                                                  One Stop/Other Employment Agency

        Minority Publication                                              MSN.com                                                    Open House

        The Chief                                                         Craigslist.com                                             Other Academy/State Exam

        The Employment Guide                                              Flipdog.com                                                Poster/Ad (bus, billboard, bus bench, taxi)

        Trade Journal                                                     Other Website                                              Radio

        Other Newspaper/Publication                                                                                                  Referred by a Friend

                                                                                                                                     Religious/Church Recruitment

                                                                                                                                     Television

                                                                                                                                     Walk In
                                                                                                                                                                                     7
                                                                                                                                       *APP*
                                      Broward Sheriff’s Office
                                      Bureau of Human Resources
                                      2601 West Broward Boulevard
                                      Fort Lauderdale, Florida 33312
                                            Human Resources 954-321-4400
                                            Jobline: 888-276-7827
                                            TDD Line: 954-831-8948
                                            Online: www.sheriff.org




_________________________________________________________________________________________________________________________
Date of Application                     Position You Are Applying For                    Social Security Number

_________________________________________________________________________________________________________________________
Last Name                               First Name                                       Middle Name


EMPLOYMENT HISTORY                                                                                                                     SECTION II
LIST ALL FULL-TIME, PART-TIME, TEMPORARY and SELF-EMPLOYMENT you have had during the last 7 years, ensuring that ALL time is accounted for. Start with your
CURRENT employment. Self-employment requires supporting documentation. If you have had more than 11 jobs, please photocopy page 3.


 To (mm/dd/yy)
                                      Position                                                                        Phone

 From (mm/dd/yy)
                                      Employer                                                                        Fax

 Starting Salary $                                                                                                    Supervisor
                                      Street Address                                                                  (Full Name)

 Ending Salary $
                                      City                                        State                 Zip

     Full Time       Part Time
                                      Reason for Leaving


 Do you have any objections to having your current employer contacted?        YES           NO



 Between these jobs (If Applicable)          Unemployed          In School          From (mm/dd/yy) _______________    To (mm/dd/yy) _______________



 To (mm/dd/yy)
                                      Position                                                                        Phone

 From (mm/dd/yy)
                                      Employer                                                                        Fax

 Starting Salary $                                                                                                    Supervisor
                                      Street Address                                                                  (Full Name)

 Ending Salary $
                                      City                                        State                 Zip

     Full Time       Part Time
                                      Reason for Leaving


 Between these jobs (If Applicable)          Unemployed         In School           From (mm/dd/yy) _______________    To (mm/dd/yy) _______________



 To (mm/dd/yy)
                                      Position                                                                        Phone

 From (mm/dd/yy)
                                      Employer                                                                        Fax

 Starting Salary $                                                                                                    Supervisor
                                      Street Address                                                                  (Full Name)

 Ending Salary $
                                      City                                          State               Zip

     Full Time       Part Time
                                      Reason for Leaving


 Between these jobs (If Applicable)          Unemployed         In School           From (mm/dd/yy) _______________    To (mm/dd/yy) _______________
EMPLOYMENT HISTORY CONTINUED                                                                                           SECTION II


To (mm/dd/yy)
                                     Position                                                           Phone

From (mm/dd/yy)
                                     Employer                                                           Fax

Starting Salary $                                                                                       Supervisor
                                     Street Address                                                     (Full Name)

Ending Salary $
                                     City                             State                Zip

    Full Time       Part Time
                                     Reason for Leaving


Between these jobs (If Applicable)      Unemployed        In School   From (mm/dd/yy) _______________   To (mm/dd/yy) _______________




To (mm/dd/yy)
                                     Position                                                           Phone

From (mm/dd/yy)
                                     Employer                                                           Fax

Starting Salary $                                                                                       Supervisor
                                     Street Address                                                     (Full Name)

Ending Salary $
                                     City                             State                Zip

    Full Time       Part Time
                                     Reason for Leaving


Between these jobs (If Applicable)      Unemployed        In School   From (mm/dd/yy) _______________   To (mm/dd/yy) _______________




To (mm/dd/yy)
                                     Position                                                           Phone

From (mm/dd/yy)
                                     Employer                                                           Fax

Starting Salary $                                                                                       Supervisor
                                     Street Address                                                     (Full Name)

Ending Salary $
                                     City                             State                Zip

    Full Time       Part Time
                                     Reason for Leaving


Between these jobs (If Applicable)      Unemployed        In School   From (mm/dd/yy) _______________   To (mm/dd/yy) _______________




To (mm/dd/yy)
                                     Position                                                           Phone

From (mm/dd/yy)
                                     Employer                                                           Fax

Starting Salary $                                                                                       Supervisor
                                     Street Address                                                     (Full Name)

Ending Salary $
                                     City                             State               Zip

    Full Time       Part Time
                                     Reason for Leaving


Between these jobs (If Applicable)      Unemployed        In School   From (mm/dd/yy) _______________   To (mm/dd/yy) _______________




                                                                                                                                        2
EMPLOYMENT HISTORY CONTINUED                                                                                              SECTION II


To (mm/dd/yy)
                                     Position                                                             Phone

From (mm/dd/yy)
                                     Employer                                                             Fax

Starting Salary $                                                                                         Supervisor
                                     Street Address                                                       (Full Name)

Ending Salary $
                                     City                             State                  Zip

    Full Time       Part Time
                                     Reason for Leaving


Between these jobs (If Applicable)   Unemployed           In School    From (mm/dd/yy) _______________   To (mm/dd/yy) _______________




To (mm/dd/yy)
                                     Position                                                             Phone

From (mm/dd/yy)
                                     Employer                                                             Fax

Starting Salary $                                                                                         Supervisor
                                     Street Address                                                       (Full Name)

Ending Salary $
                                     City                             State                 Zip

    Full Time       Part Time
                                     Reason for Leaving


Between these jobs (If Applicable)   Unemployed           In School   From (mm/dd/yy) _______________    To (mm/dd/yy) _______________




To (mm/dd/yy)
                                     Position                                                             Phone

From (mm/dd/yy)
                                     Employer                                                             Fax

Starting Salary $                                                                                         Supervisor
                                     Street Address                                                       (Full Name)

Ending Salary $
                                     City                             State                Zip

    Full Time       Part Time
                                     Reason for Leaving


Between these jobs (If Applicable)   Unemployed           In School   From (mm/dd/yy) _______________    To (mm/dd/yy) _______________




To (mm/dd/yy)
                                     Position                                                             Phone

From (mm/dd/yy)
                                     Employer                                                             Fax

Starting Salary $                                                                                         Supervisor
                                     Street Address                                                       (Full Name)

Ending Salary $
                                     City                             State                 Zip

    Full Time       Part Time
                                     Reason for Leaving


Between these jobs (If Applicable)   Unemployed           In School    From (mm/dd/yy) _______________   To (mm/dd/yy) _______________




                                                                                                                                         3
ADDITIONAL EMPLOYMENT INFORMATION                                                                                                                 SECTION II
1. Have you ever been dismissed from any employment; been asked to resign from any employment; resigned from any employment following allegations of
misconduct or unsatisfactory performance; or left a job by mutual agreement.  YES        NO

If YES, please provide details below. Please be specific and attach additional pages if necessary.


_________________________________________________________________________________________________
Date (mm/dd/yy)                                    Name of Agency/Employer                                            Position


_________________________________________________________________________________________________
Reason/Outcome


_________________________________________________________________________________________________
Date (mm/dd/yy)                                    Name of Agency/Employer                                            Position


_________________________________________________________________________________________________
Reason/Outcome
2. Have you ever received an unsatisfactory performance evaluation(s) or any disciplinary action(s), including verbal or written reprimands, from an employer?
Attach additional pages if necessary.      YES        NO
If YES, please provide details below.


_________________________________________________________________________________________________
Date (mm/dd/yy)                                    Name of Agency/Employer                                            Position


_________________________________________________________________________________________________
Circumstances


_________________________________________________________________________________________________
Date (mm/dd/yy)                                    Name of Agency/Employer                                            Position


_________________________________________________________________________________________________
Circumstances
3. Have you ever performed any service for any law enforcement agency or been employed by any law enforcement/corrections agency not listed in this
application? Attach additional pages if necessary.       YES       NO

If YES, please provide details below.

________________________________________________________________________________________________
From (mm/dd/yy)           To (mm/dd/yy)                Name of Agency/Employer                                           Position


_________________________________________________________________________________________________
Reason for Leaving


_________________________________________________________________________________________________
From (mm/dd/yy)           To (mm/dd/yy)                Name of Agency/Employer                                           Position


_________________________________________________________________________________________________
Reason for Leaving
4. Are you an owner, partner, or corporate officer in any other business not listed as an employer?             YES    NO
If YES, please provide details below.

__________________________________________________________________________________________________________________________________________
Date (mm/dd/yy)                           Business Name                                             Type of Business


__________________________________________________________________________________________________________________________________________
Date (mm/dd/yy)                           Business Name                                             Type of Business


APPLICATIONS WITH OTHER AGENCIES                                                                                                                  SECTION II
Please list ALL public safety agencies to include law enforcement, corrections, and fire rescue and emergency services to which you have applied within the past
5 years. Include all testing completed and results, and/or why you were not hired. Attach additional pages if necessary.
 Agency                                     Position                                     Application Date (mm/yy)                Results/Status




                                                                                                                                                                 4
RESIDENTIAL BACKGROUND                                                                                                                               SECTION II
Please list all residential addresses you have lived at during the past 7 years. Please do not use PO Box Addresses. Begin with your current residence and include
any addresses you may have resided at during school or the military. Attach additional pages if necessary.


 From (mm/yy)          To (mm/yy)        Street Address                                             Apt.      City                           State      Zip Code

                          Current




DRIVING HISTORY                                                                                                                                      SECTION II
List ALL driver’s licenses issued to you, starting with your current driver’s license.


 State          Type                                               Issue Date(mm/yy)                 Expiration/Surrender Date (mm/yy)




Is your driver’s license CURRENTLY valid?         YES         NO
Has your driver’s license EVER been revoked/suspended or have you ever been refused a driver’s license?              YES           NO

 If you answered Yes, please provide details:




MILITARY                                                                                                                                             SECTION II
Have you ever served in the Armed Forces of the United States (including Reserves and National Guard)?                           YES        NO
DD-214 Member 4 form must be provided for each enlistment period.

               Branch of Military                                  List All Disciplinary Offenses
                                                                        NONE

                       To (mm/yy)


                  From (mm/yy)                                     List All Disciplinary Action(s), including non-judicial punishment(s).
                                                                        NONE
   Character of Service (Box 24
   on DD-214 Member 4 Form)



               Branch of Military                                  List All Disciplinary Offenses
                                                                        NONE

                       To (mm/yy)


                  From (mm/yy)                                     List All Disciplinary Action(s), including non-judicial punishment(s).
                                                                        NONE
   Character of Service (Box 24
   on DD-214 Member 4 Form)




                                                                                                                                                                     5
                           PERSONAL REFERENCE FORM                                                                                    SECTION II
                           List 5 personal references and their contact information. References cannot be related to each other, family members or
                           current/former supervisors.




__________________________________________________________________________________________
Reference’s Name (PRINT)                                                        Reference’s Daytime Phone Number                                 Extension

__________________________________________________________________________________________________________________________________________
References Occupation                                                     Reference’s Other Phone Number                          Extension

__________________________________________________________________________________________________________________________________________
Reference’s City                                                          State

__________________________________________________________________________________________________________________________________________
Reference’s E-Mail




__________________________________________________________________________________________________________________________________________
Reference’s Name (PRINT)                                                  Reference’s Daytime Phone Number                        Extension

__________________________________________________________________________________________________________________________________________
References Occupation                                                     Reference’s Other Phone Number                          Extension

__________________________________________________________________________________________________________________________________________
Reference’s City                                                          State

__________________________________________________________________________________________________________________________________________
Reference’s E-Mail




__________________________________________________________________________________________________________________________________________
Reference’s Name (PRINT)                                                  Reference’s Daytime Phone Number                        Extension

__________________________________________________________________________________________________________________________________________
References Occupation                                                     Reference’s Other Phone Number                         Extension

__________________________________________________________________________________________________________________________________________
Reference’s City                                                          State

__________________________________________________________________________________________________________________________________________
Reference’s E-Mail




__________________________________________________________________________________________________________________________________________
Reference’s Name (PRINT)                                                  Reference’s Daytime Phone Number                        Extension

__________________________________________________________________________________________________________________________________________
References Occupation                                                     Reference’s Other Phone Number                          Extension

__________________________________________________________________________________________________________________________________________
Reference’s City                                                          State

__________________________________________________________________________________________________________________________________________
Reference’s E-Mail




__________________________________________________________________________________________________________________________________________
Reference’s Name (PRINT)                                                  Reference’s Daytime Phone Number                        Extension

__________________________________________________________________________________________________________________________________________
References Occupation                                                     Reference’s Other Phone Number                          Extension

__________________________________________________________________________________________________________________________________________
Reference’s City                                                          State

__________________________________________________________________________________________________________________________________________
Reference’s E-Mail




                                                                                                                                                         6
NEIGHBOR REFERENCES                                                                                                     SECTION II
To Be Completed By Applicants For Deputy Sheriff Positions Only (Law Enforcement and Detention)
List 4 neighbors from where you currently reside (For example households to the left, right, in front, and behind).



_________________________________________________________________________________________________________________________________________
Last Name                                                                          First Name


_________________________________________________________________________________________________________________________________________
Street Address                                                                                        Apt.


_________________________________________________________________________________________________________________________________________
City                                                                      State                                         Zip Code


_________________________________________________________________________________________________________________________________________
Home Phone                           Work Phone                  Extension                            Cell Phone/ Other




_________________________________________________________________________________________________________________________________________
Last Name                                                                          First Name


_________________________________________________________________________________________________________________________________________
Street Address                                                                                        Apt.


_________________________________________________________________________________________________________________________________________
City                                                                      State                                         Zip Code


_________________________________________________________________________________________________________________________________________
Home Phone                           Work Phone                  Extension                            Cell Phone/ Other




_________________________________________________________________________________________________________________________________________
Last Name                                                                          First Name


_________________________________________________________________________________________________________________________________________
Street Address                                                                                        Apt.


_________________________________________________________________________________________________________________________________________
City                                                                      State                                         Zip Code


_________________________________________________________________________________________________________________________________________
Home Phone                           Work Phone                  Extension                            Cell Phone/ Other




_________________________________________________________________________________________________________________________________________
Last Name                                                                          First Name


_________________________________________________________________________________________________________________________________________
Street Address                                                                                        Apt.


_________________________________________________________________________________________________________________________________________
City                                                                      State                                         Zip Code


_________________________________________________________________________________________________________________________________________
Home Phone                           Work Phone                  Extension                            Cell Phone/ Other




                                                                                                                                            7
FDLE BACKGROUND INVESTIGATION WAIVER                                                                                                                                  SECTION II




                                                                                                                                                                        CJSTC
                                                        AUTHORITY FOR RELEASE
Florida Department of                                                                                                                                                     58
Law Enforcement
                                                           OF INFORMATION
                                                           (Background Investigation Waiver)
                                                 Incorporated by Reference in Rule11B-27.0022(2)(b), F.A.C

To:         Concerned Person or Authorized                                  APPLICANT’S NAME: ____________________________________________________________
            Representative of Any Organization,
            Institution or Repository of Records                            DATE OF BIRTH: ________________________________________________________________

                                                                            LAST FOUR DIGITS OF SOCIAL SECURITY NUMBER: _________________________________

AGENCY REQUESTING BACKGROUND INFORMATION: Broward Sheriff’s Office
ADDRESS: 2601 West Broward Blvd., Fort Lauderdale, FL 33312

Having made application for certification or employment as a law enforcement, correctional, or correctional probation officer within the state of Florida, I hereby authorize for one year,
from the date of execution hereof, any authorized representative of a Florida criminal justice agency or a Regional Criminal Justice Selection Center bearing this release to obtain any
information pertaining to my employment, credit history, education, residence, academic achievement, personal information, work performance, background investigations, polygraph
examinations, any and all internal affairs investigations or disciplinary records, including any files that are deemed to be confidential and/or sealed.

I also authorize release of any criminal justice records of arrests, citations, detentions, probation and parole records, or any police reports or other police records in which I may be named
for any reason, including any files that are deemed to be juvenile and confidential. I hereby direct you to release this information upon the request of the bearer, whether in person or by
correspondence. I further authorize the bearer to make copies of these records.

This release is executed with the full knowledge and understanding that these records and information are for the official use of a Florida criminal justice agency or Regional Criminal
Justice Selection Center in fulfilling official responsibilities, which may include sharing the records or information with other criminal justice agencies, Regional Criminal Justice Selection
Centers or the State of Florida or release to third parties as may be required by Florida public records laws. I hereby release you, as the custodian of such records, and employer,
educational institution, physician, hospital or other repository or medical records, credit bureau or consumer reporting agency, including its officers, employees, and related personnel,
both individually and collectively, from any and all liability for damages of whatever kind, which may at any time result to me, my heirs, family or associates because of compliance with
this authorization and request to release information, or any attempt to comply with it. A copy of this form will be as effective as the original.

I hereby authorize the National Records Center, St. Louis, Missouri, or other custodian of my military record to release information or copies from my military personnel and related
medical records, including a copy of my DD 214, Report of Separation, or other official documents from the United Stated Military denoting discharge status or current active military
status to:

Broward Sheriff’s Office – 2601 West Broward Blvd., Fort Lauderdale, FL 33312

Section 768.095, F.S., titled Employer Immunity from Liability; disclosure of information regarding former or current employees states: An employer who discloses information about a
former or current employee to a prospective employer of the former or current employee upon request of the prospective employer or of the former or current employee, is immune from
civil liability for such disclosure of its consequences, unless it is shown by clear and convincing evidence that the information disclosed by the former or current employer was
knowingly false or violated any civil right of the former or current employee protected under chapter 760, Florida Statutes. Pursuant to Sections 943.134(2)(a) and (4), F.S.,
Chapter 2001-94, Laws of Florida, disclosure of information is required unless contrary to state or federal law. Civil penalties may be available for refusal
to disclose non-privileged legally obtainable information.

Applicant’s Signature________________________________________________________                                                  Date _____________________

Applicant’s Address ___________________________________________________________________________________________

                                                                                         AFFIDAVIT

STATE OF FLORIDA, COUNTY OF_____________________________________ The forgoing instrument was acknowledged before me this date __________________________

By: ____________________________________________________________________who is personally known ______________________________________________________

or who has produced identification. Type of identification: _________________________________________________________________________________________________

_____________________________________________________________________                               ______________________________________________________________________
                     Notary’s Signature                                                              Print, type, or stamp Commissioned Name of Notary

Notary Seal:_______________________________________________________________. Upon witnessing the applicant signing of this affidavit, the notary public shall
complete the notary block.

Effective: 8/9/2001 Pursuant to                                              Original – Employing Agency                             Commission-Approved Revisions: 8/6/2009
Sections 943.134(2)(a) and (4), F.S.                                                                                                    Form Effective Date: 06/03/2010



                                                                                                                                                                                            8
                                    Broward Sheriff’s Office
                                    Bureau of Human Resources
                                    2601 West Broward Boulevard
                                    Fort Lauderdale, Florida 33312
                                               Human Resources: 954-321-4400
                                               Jobline: 888-276-7827
                                               TDD Line: 954-831-8948
                                               Online: www.sheriff.org




ATTEST, CONSENT, AUTHORIZE, AND RELEASE                                                                                                                    SECTION II

I, ______________________________________________________________________________________________________,(PRINT YOUR FULL NAME) thoroughly
understand that I am being considered for employment in the position for which I have applied, and consent to submitting to a background investigation and other selection
processes which may include, but not be limited to: fingerprint processing, polygraph, post-conditional employment offer medical and/or urinalysis, psychological evaluation,
job interview, and other means deemed necessary and proper by the Broward Sheriff’s Office to complete its investigation as to my fitness and suitability for the classification
for which I have applied. I thoroughly understand that I must successfully complete the above-mentioned process. I am attesting that I understand and meet all of the
minimum requirements as stated on the job announcement.

I am seeking employment on the basis that I know that the Broward Sheriff’s Office, or other individuals or agencies, will develop no unfavorable information, with the
exception of what I have indicated in this application, which has been thoroughly explained by me in detail during the hiring process. By signing this document, I certify that all
of the information contained in this entire application and all documents submitted are true and complete to the best of my knowledge. I understand that all information is
subject to investigation and that omission, falsification, misrepresentation, or other unfavorable information developed is sufficient cause for removal of my name for
consideration for employment or dismissal from service.

I understand that the application and all documents submitted are the property of the Broward Sheriff’s Office and non-exempt information contained in said forms and
documents is public record.

I understand that the Broward Sheriff’s Office will not reimburse any expenses I might incur in seeking this position. I recognize that the time required to process and select
employees for this position may be lengthy and time consuming. No promises or commitments are expected by me as to a time when a hiring decision and/or actual hiring
might take place.

I understand that unless defined by applicable law, any employment relationship with the Broward Sheriff’s Office is "at will", that I may be discharged at any time with or
without cause, and that this "at will" relationship may not be changed unless authorized, in writing, by the Sheriff.

I understand and agree that any employment offered to me will be contingent upon my acceptance of compensatory time off instead of cash payments of overtime hours that I
work, to the extent allowed by law and that the Sheriff has the absolute discretion to periodically substitute cash, in whole or in part, for my accrued compensatory time.

I understand that the Broward Sheriff’s Office is a Drug-Free Workplace and that employees are subject to random drug testing.

I authorize and direct any persons or organizations to release and furnish records and information as may be relevant to determine my fitness and suitability for employment in
the position for which I have applied.

I further agree to execute any authorizations as may be required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) for healthcare providers to release
the necessary medical information to process my application for employment.

I agree to conform to rules, regulations, and orders of the Broward Sheriff’s Office and acknowledge that these rules, regulations, and orders may be changed, interpreted,
withdrawn, or added to by the Broward Sheriff’s Office at its discretion at any time and without prior notice to me.

This authorization is executed with full knowledge and understanding that information and/or copies of records disclosed shall become the property of the Broward Sheriff's
Office, shall be used for official employment evaluation, and are used as selection criterion only where related to performance of the job for which I have applied; that the
Broward Sheriff's Office will take appropriate measures to protect aforementioned information and/or copies of records against unauthorized disclosure; and that certain non-
exempt portions of the information and/or copies of records disclosed may be made available for inspection by third parties pursuant to public records and other laws.

I understand and consent to all of the above statements and conditions.




Applicant’s Signature_________________________________________________________                                                     Date _________________________


                                                                               AFFIDAVIT
STATE OF ________________________________________                                              COUNTY OF _____________________________________

Before me personally appeared ________________________________________ who says that he/she executed the above instrument of his
or her own free will and accord, with full knowledge of the purpose therefore.

Sworn and subscribed in my presence this ___________ day of ____________________________, 20____________. My Commission

expires on _____________________________, 20___________. Personally Known __________________________________ - or -

Produced Identification ________________________________ Notary Public: ___________________________________________________

Type of identification produced: ________________________________________________________




                                                                                                                                                                                 9
                                    Broward Sheriff’s Office
                                    Bureau of Human Resources
                                    2601 West Broward Boulevard
                                    Fort Lauderdale, Florida 33312
                                            Human Resources: 954-321-4400
                                            Jobline: 888-276-7827
                                            TDD Line: 954-831-8948
                                            Online: www.sheriff.org




CONSUMER CREDIT REPORTING
DISCLOSURE AND AUTHORIZATION                                                                                                                               SECTION II
By this document, the Broward Sheriff’s Office discloses that a consumer credit report may be obtained for employment purposes as a part of the pre-employment background
investigation. If hired, this authorization shall remain on file and shall serve as an ongoing authorization for the Broward Sheriff’s Office to procure consumer credit reports at
any time during your employment period.


_______________________________________________________________________________________________________________________________________
First Name (PRINT)                   Middle Name (PRINT)                           Last Name (PRINT)


________________________________________________________________________________________________________________________________________
Social Security Number


________________________________________________________________________________________________________________________________________
Date (mm/dd/yy)




Applicant’s Signature_________________________________________________________________                                 Date_______________________________________




                                                                               AFFIDAVIT
STATE OF ________________________________________                                              COUNTY OF _____________________________________

Before me personally appeared ________________________________________ who says that he/she executed the above instrument of his
or her own free will and accord, with full knowledge of the purpose therefore.

Sworn and subscribed in my presence this ___________ day of ____________________________, 20____________. My Commission

expires on _____________________________, 20___________. Personally Known __________________________________ - or -

Produced Identification ________________________________ Notary Public: ___________________________________________________

Type of identification produced: ________________________________________________________




                                                                                                                                                                               10
REQUIRED DOCUMENTS                                                                                                                                      SECTION II
Below is a list of all required documents that must be submitted with this application. Each document should be photocopied on a separate piece of paper and
must be clear and legible.




                                          Original documents must be presented for comparison
                                                                      REQUIRED DOCUMENTATION
                                                                      Pages 8, 9 and 10 must be notarized




                   For Deputy Sheriff or
                                                                                                                 For Civilian Positions
                Detention Deputy Positions
                                                                                                •    Birth Certificate or valid U.S. Passport or Certificate of Naturalization
    •    Birth Certificate or Certificate of Naturalization
                                                                                                •    Social Security Card (with current legal name and signature)
    •    Social Security Card (with current legal name and signature)
                                                                                                •    Driver’s License or State ID (with current legal name/address)
    •    Driver’s License (with current legal name/address)
                                                                                                •    Resident Alien Card: front & back (with current legal name)
    •    Name change document(s) (such as marriage license, divorce
         decree, court document for name change, etc.) for EACH name                            •    Name change document(s) (such as marriage license, divorce
         used                                                                                        decree, court document for name change, etc.) for EACH name
                                                                                                     used
    •    High School Diploma, transcript, or equivalent
                                                                                                •    High School Diploma, transcript, or equivalent
    •    College Diploma(s) or transcript(s)
                                                                                                •    College Diploma(s) or transcript(s)
    •    Florida Department of Law Enforcement (FDLE) Certification

    •    DD-214 Member 4 Form (for each enlistment period)                                      •    DD-214 Member 4 Form (for each enlistment period)

    •    Entire driving history (from each state you have held a driver’s                       •    Court Disposition(s) for ALL arrests/charges and copies of police
         license during the past 7 years)                                                            reports

    •    Court Disposition(s) for ALL arrests/charges and copies of police                      •    Documents for each year of self-employment (include corporate
         report(s)                                                                                   papers, business licenses, etc.)

    •    Documents for each year of self-employment (include corporate
         papers, business licenses, etc.)

    •    Performance Evaluations (for last 3 years, for current Law
         Enforcement or Corrections Officers only)




                                                                                                                                                                             11

				
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