Law Enforcement Academy: Pre-Employment Application

Law Enforcement Academy students must be citizens of the United States of America or lawfully residing within the United States of America. Students may not be convicted of a felony.

Answer all questions fully and truthfully. Very few things will keep you from being selected to this academy. However, a false statement made on this application will result in non-acceptance and could result in your dismissal from the Academy if it is discovered while you are attending the Academy.

If any question does not apply to you, please indicate so by entering N/A.

Candidates will need to include copies of the following documents in order to submit their application.

· Driver’s License

· Unofficial High school diploma and/or college transcripts (if applicable)

· Resume including all employment experience

After your application has been received and reviewed, the final step in the process will be an interview with the Law Enforcement Academy Board.

Personal Information Section

First Name

Middle Name

Last Name

Social Security Number

Birthdate

Place of Birth (City, State)

Are you a U.S. citizen?

Mailing Address

Country

Street

City

Region

Postal Code

Cell Phone Number

Email Address

Height

Weight (lbs)

Sex

Hair Color

Eye Color

List any other names you have used or been known by, and a brief statement giving reasons for alternate names. If none, state "N/A".

Upload copy of Driver's License

Civil Service Position History

Have you ever applied for a Civil Service Position?

Date Taken

Location of Examination

Position

Results

Driving Record

Do you possess a valid driver's license?

Type

Driver's License #

State

Date Issued

Expiration Date

Do you own a motor vehicle?

Make

Model

Year of Vehicle

Registration Number

Have you ever been ticketed/convicted of any vehicle or traffic violation?

Please list the date, charge, police agency, court, and disposition for all.

Criminal Record

Have you ever been arrested for a crime, or do you have any pending criminal charges?

Please provide details.

Employment & Experience

Upload a copy of your resume

Educational Qualifications (List the requested information concerning all high schools, colleges, and universities you have attended, starting with the present/most recent and going backwards)

Do you have education information to share (1st response)?

Education Information #1: Date (From-To)

Education Information #1: Name of Educational Institution

Education Information #1: Address (Street, City, State, Zip)

Education Information #1: Grade Average

Education Information #1: Grades Attended

Education Information #1: Extra-curricular Activities

Education Information #1: Graduated (Yes/No)? If Yes, indicate type of degree/diploma and completion date.

Do you have additional education information to share (response #2)?

Education Information #2: Date (From-To)

Education Information #2: Name of Education Institution

Education Information #2: Address (Street, City, State, Zip)

Education Information #2: Grade Average

Education Information #2: Grades Attended

Education Information #2: Extra-curricular Activities

Education Information #2: Date Graduated (Yes/No)? If Yes, indicate type of diploma/degree and completion date.

Do you have additional education information to share (response #3)?

Education Information #3: Date (From-To)

Education Information #3: Name of Educational Institution

Education Information #3: Address (Street, City, State, Zip)

Education Information #3: Grade Average

Education Information #3: Grades Attended

Education Information #3: Extra-curricular Activities

Education Information #3: Date Graduated (Yes/No)? If Yes, indicate type of diploma/degree and completion date.

Were you ever subjected to any disciplinary actions or proceedings at any educational institution you attended?

Please provide details.

Upload copies of High School diploma and/or college transcripts.

Military Service

Do you have or have you ever had any selective service classification?

Please provide the following details:
1. Date
2. Classification Number
3. Issuing Authority

Have you ever served in the Armed Forces of the United States?

Please provide the following details:
1. Dates (From-To)
2. Branch
3. Service Number
4. Type of Discharge

What was your highest rank attained?

Have you ever received a discharge or separation from the military?

What was your last rank?

Are you now serving or have you ever served in any reserve or National Guard unit?

Please provide details.

Were you ever subjected to any disciplinary proceedings while in military service, including court martial, summary proceedings, or Article 15 actions?

Please provide the following details:
1. Date
2. Charge
3. Location or Unit
4. Disposition
5. Explanation

What types of training or education did you complete while in military service? (Do not include basic training.)

Upload copy of Armed Forces Discharge papers.

References: Please list the information below concerning persons who may attest to your character, integrity, and fitness for the Academy. List 4 personal (friends or neighbors) and 3 business (supervisors or coworkers) references. Do not include any relatives for personal references.

Personal Reference #1
1. Name
2. Phone Number
3. Address (Street, City, State, Zip)

Personal Reference #2
1. Name
2. Phone Number
3. Address (Street, City, State, Zip)

Personal Reference #3
1. Name
2. Phone Number
3. Address (Street, City, State, Zip)

Personal Reference #4
1. Name
2. Phone Number
3. Address (Street, City, State, Zip)

Business Reference #1
1. Name
2. Phone Number
3. Address (Street, City, State, Zip)

Business Reference #2
1. Name
2. Phone Number
3. Address (Street, City, State, Zip)

Business Reference #3
1. Name
2. Phone Number
3. Address (Street, City, State, Zip)

Affirmation of Truthfulness

I attest and confirm that I am the person whom the foregoing application concerns, that I completed the application in my own hand, and that the answers I have given to each and every question therein are full, complete, true, and correct, to the best of my knowledge.

Notice: False statements made herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of the New York State Penal Law.

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Law Enforcement Academy: Pre-Employment Application