Application for Police Employment

The City of Alamosa is an Equal Opportunity Employer and will consider all applications without regard to race, marital status, sex, age, color, religion, national origin, veteran status, disability or any other characteristic protected by law.

Instructions

You must complete this application yourself. Your ability to completely and honestly complete this application is part of the process to determine your suitability for employment. If you intentionally leave out any information that might be detrimental to obtaining a job, such as past drug use or other crimes, it will automatically eliminate you from consideration for employment. The fact that you may have used drugs, committed a theft or another illegal act will not automatically eliminate you, but the omission of it during the application process will. Once submitted, this application becomes the property of the City of Alamosa.

Application

Position(s) Applied for: (required)

Date of Application (required)

How did you learn about us? (required)

Advertisement

Employment Agency

Friend / Family

Walk-In

Other

If other, please specify

---

Applicant Information

Full Name (First Middle Last) (required)

Street Address (required)

Street Address Line 2

City (required)

State (required)

Postal / Zip Code (required)

Email

Phone (###-###-####) (required)

Are you 21 years of age or older? (required)

Yes

No

Have you ever filed an application with us before? (required)

Yes

No

If Yes, give date:

Have you ever been employed with us before? (required)

Yes

No

If Yes, what was the reason for leaving and what date did employment end?

Are you related to any current City of Alamosa employee? (required)

Yes

No

If Yes, state who and describe your relationship.

Are you able to be lawfully employed in this country? (required)

Yes

No

On what date would you be available for work? (required)

Do you have a valid driver's license? (required)

Yes

No

You are available to work: (required)

Full Time

Part Time

Shift Work

Temporary

Are you currently on "lay-off" status and subject to recall? (required)

Yes

No

Can you travel if required? (required)

Yes

No

Are you a licensed peace officer in the State of Colorado? (required)

Yes

No

Have you ever held a Peace Officer Certification in another state? (required)

Yes

No

If yes, what state and expiration date.

Has your peace officer’s license ever been suspended? (required)

Yes

No

If yes, explain the circumstances.

---

Military Service

If you have previously served in the Military, please provide a copy of your DD214 (Member 4)

Branch

Date of Service From (mm-dd-yyyy)

Date of Service To (mm-dd-yyyy)

Reserve Status

Type of Discharge

If not honorable, explain.

Grade and duty assignment at discharge/separation

Are you registered for the Selective Service?

Yes

No

Are you a member of the Reserves or National Guard?

Yes

No

If yes, give unit, location, grade, and duty assignment

---

Education: High School or GED

Name of School

Course of Study

No. of Years Completed

Degree or Diploma

---

Education: Business/Trade

Name of School

Course of Study

No. of Years Completed

Degree or Diploma

---

Education: College

Name of School

Course of Study

No. of Years Completed

Degree or Diploma

Indicate any foreign languages you can speak, read and/or write.

Briefly list any training or skills, including firearms, that would be of assistance in the job you are applying for. If you have any copies of certificates for any training, please attach them to the application: (required)

Please list any social internet sites (Facebook, MySpace, Twitter, personal blogs) that youhave an active or past account with: (required)

---

Personal History

Do you know of any reason that you could not pass a background check? (required)

Yes

No

Have you ever been fired or asked to resign from a job? (required)

Yes

No

Have you ever received disciplinary action from an employer? (required)

Yes

No

Have you ever stolen from an employer? (required)

Yes

No

Have you ever committed a crime for which you were not arrested? (required)

Yes

No

Have you ever assisted someone in committing a crime? (required)

Yes

No

Have you ever falsified a police report? (required)

Yes

No

Have you ever accepted money not to report a crime? (required)

Yes

No

Have you ever slept on the job? (required)

Yes

No

Has any driver’s license issued to you ever been suspended or revoked? (required)

Yes

No

Have you ever used, sold, or otherwise handled in an illegal manner any controlled substance? (required)

Yes

No

Have you ever been bonded? (required)

Yes

No

Have you ever been refused bond? (required)

Yes

No

If you answered "yes" to any of the questions listed above, please write a brief explanation for the question(s). List the question by number. If you are interviewed, you will be asked about any “yes” answers. Any “yes” answers will be closely examined during a background check. A “yes” answer does not automatically eliminate you from consideration for employment. Your omission of these facts will automatically eliminate you from consideration.

---

Traffic, Civil Court, and Criminal Record: Please list your history of any traffic citations, any civil court actions in which you were or are a defendant, any arrests, convictions, and court actions. If additional space is needed, list on a separate sheet.

1 (Type of case / Jurisdiction / City, State)

2 (Type of case / Jurisdiction / City, State)

3 (Type of case / Jurisdiction / City, State)

4 (Type of case / Jurisdiction / City, State)

Attach additional as needed.

---

Residences: List all residences where you have lived during the past five years. Begin with your present address and work backwards. List the complete address including street number, street name, city, state, and zip code.

1 (Street # & Name, City, State, Zip)

2 (Street # & Name, City, State, Zip)

3 (Street # & Name, City, State, Zip)

4 (Street # & Name, City, State, Zip)

---

Employment Experience: Start with your present or last job. Include any job related to military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status. This section must be completed, even if a resume is attached.

1) Company Name (required)

Phone Number (required)

Addresss (Street, City, State, Zip) (required)

Dates Employed

Name of Supervisor (required)

Job Title & Duties (required)

Reason for Leaving (required)

2) Company Name

Phone Number

Addresss (Street, City, State, Zip)

Dates Employed

Name of Supervisor

Job Title & Duties

Reason for Leaving

3) Company Name

Phone Number

Addresss (Street, City, State, Zip)

Dates Employed

Name of Supervisor

Job Title & Duties

Reason for Leaving

---

Additional Information

List professional, trade, business or civic activities and offices held. You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status.

Other Qualifications Summarize special job related skills and qualifications acquired from employment or other experience.

---

Specialized Skills-List Skills/Equipment Operated

Computer Hardware/Software

Office Equipment

Other (list)

State any additional information you feel may be helpful to us in considering your application.

---

Note to Applicants. DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A description of the activities involved in such a job or occupation is attached.

Yes

No

---

References: Give three references, not relatives, who have definite knowledge of your business or professional qualifications for the position of volunteer firefighter. Do not repeat names of supervisors listed under employment history.

Reference 1 (Name, Address, Phone, Email) (required)

Reference 2 (Name, Address, Phone, Email) (required)

Reference 3 (Name, Address, Phone, Email) (required)

Upload Resume

---

Application Form Waiver

Please read each statement carefully and acknowledge by checking each box before signing. (required)

All information contained in the application is subject to verification. The City of Alamosa will conduct background checks including, but not limited to, work references, driving records, criminal background records, and educational attainment.

I understand an employment offer is contingent upon successful completion of a pre-employment alcohol/drug test, review of work references, and results of the background check.

I understand that specific positions at the City of Alamosa require proof of an acceptable driving record and that maintaining an acceptable driving record is a condition of continued employment.

I understand that the CITY OF ALAMOSA-EMPLOYEES ("the Organization") may obtain information about me from a consumer reporting agency for consideration of employment with the Organization. Thus, I may be the subject of a "consumer report" which may include information about my character, general reputation, personal characteristics, and/or mode of living. These reports may contain information regarding my criminal history, motor vehicle records ("driving records"), or other background checks. Please be advised that the nature and scope of the most common form of consumer report obtained with regard to applicants for employment, or continued employment is a criminal record report conducted by Background Investigation Bureau, LLC, ("BIB"), 9710 Northcross Center Court, Huntersville, NC 28078, (877) 439-3900.

I also understand that in the event I am placed in a job which does serve youth my name, date of birth, and social security number will be submitted annually to check for any criminal history record information pertaining to me, as a condition of my continued employment and that finding of information determined to be inappropriate will result in my immediate dismissal or discharge.

If employed, I agree to provide proof of identity, relevant licensure or credentials, and authorization for employment in the United States.

If employed, I agree to abide by all policies, regulations, and guidelines established by the City of Alamosa.

I certify that all the information provided herein is true and complete to the best of my knowledge. I agree and understand that omissions, misstatements, and falsifications will cause forfeiture on my part of all eligibility to any employment with the City of Alamosa and may be cause for rejection of this application, removal of my name from eligibility lists, or discharge from City service.

In addition, I give the City of Alamosa the right to investigate and verify any information obtained through the application process. Permission is granted and I release from any and all liability any employer, agency or individual assisting the City of Alamosa in providing relevant, job-related information that will assist in this process.

I understand and acknowledge that unless otherwise defined by applicable law, any employment relationship with the City of Alamosa is an “at-will” nature, which means that the employee may resign at any time and the City may discharge an employee at any time with or without cause. It is further understood that this “at-will” employment relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing.

I have read and I understand the “Application Form Waiver” and I am acknowledging the same by my dated signature hereafter.

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

There was a problem saving your submission. Please try again later.

Please wait while your submission is being saved...

Submitting...Submit

Thank you, your submission has been received.