Employment Application

Caldwell County Sheriff's Patch

Caldwell County Sheriff's Department

[{"type":"paragraph","subtype":"p","label":"To report an emergency, call 911 (where applicable) or your local law enforcement office. This form is for non-emergency contact only. We will contact you once we have received your submission, if your contact information is provided. If you do not hear from us in 24 hours, please call our office.","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Personal Information","className":"d-block"},{"type":"text","required":true,"label":"First Name","name":"First-Name","className":"col-lg-4","subtype":"text"},{"type":"text","label":"Middle Name","name":"Middle-Name","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Last Name","name":"Last-Name","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Street Address","name":"Street-Address","className":"d-block","subtype":"text"},{"type":"text","required":true,"label":"City","name":"City","className":"col-lg-4","subtype":"text"},{"type":"select","required":true,"label":"State","name":"State","className":"col-lg-4","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO","selected":true},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","required":true,"label":"ZIP Code","name":"ZIP-Code","className":"col-lg-4","subtype":"text"},{"type":"date","required":true,"label":"Date of Birth","name":"Date-of-Birth","className":"col-lg-4"},{"type":"text","required":true,"label":"Social Security Number ","name":"Applicant-social-security-number","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Driver's License Number ","name":"Applicant-drivers-license-number-","className":"col-lg-4","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"Phone Number","name":"Phone-Number","className":"col-lg-4"},{"type":"text","subtype":"email","required":true,"label":"Email","name":"email","className":"col-lg-4"},{"type":"text","subtype":"email","required":true,"label":"Email Confirmation","name":"email-confirmed","className":"col-lg-4"},{"type":"radio-group","required":true,"label":"Are you a U.S. citizen?","inline":true,"name":"us-citizen","other":true,"className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"radio-group","required":true,"label":"If selected for employment are you willing to submit to a pre-employment drug screening test?","name":"drug-screening","className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"radio-group","required":true,"label":"Have you ever been convicted of a misdemeanor or felony?","name":"misdemeanor-or-felony-conviction","className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"textarea","label":"<div><br></div>If yes, briefly explain conviction.","name":"conviction-explanation","subtype":"textarea","maxlength":750,"rows":4,"className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Position","className":"d-block"},{"type":"text","required":true,"label":"Position You are Applying For","name":"Position-You-are-Applying-For","className":"d-block","subtype":"text"},{"type":"text","label":"If applying for a position that requires POST certification, provide your POST number here. ","name":"Post-Number","className":"d-block","subtype":"text"},{"type":"date","required":true,"label":"Available Start Date","name":"Available-Start-Date","className":"col-lg-4"},{"type":"text","required":true,"label":"Desired Pay","name":"Desired-Pay","className":"col-lg-4","subtype":"text"},{"type":"checkbox-group","required":true,"label":"Employment Desired","inline":true,"name":"Employment-Desired","className":"col-lg-4","values":[{"label":"Full Time","value":"Full Time"},{"label":"Part Time","value":"Part Time"}]},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Education","className":"d-block"},{"type":"text","required":true,"label":"High School Name","name":"High-School-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"High School Address","name":"High-School-Address","className":"col-md-6","subtype":"text"},{"type":"checkbox-group","required":true,"label":"Did you graduate / receive your GED?","inline":true,"name":"Did-you-graduate--receive-your-GED","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"text","required":true,"label":"Graduation Year","name":"Graduation-Year","className":"col-md-6","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"text","required":true,"label":"College / Academy Name","name":"College--Academy-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"College / Academy Address","name":"College--Academy-Address","className":"col-md-6","subtype":"text"},{"type":"checkbox-group","required":true,"label":"Did you graduate / receive POST certification? ","inline":true,"name":"Did-you-graduate--receive-POST-certification-","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"text","required":true,"label":"Graduation / Certification Year","name":"Graduation--Certification-Year","className":"col-md-6","subtype":"text"},{"type":"text","label":"Degree Obtained","name":"Degree-Obtained","className":"d-block","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"text","label":"Other Education / Training Institution Name","name":"Other-Education--Training-Institution-Name","className":"col-md-6","subtype":"text"},{"type":"text","label":"Other Education / Training Institution Address","name":"Other-Education--Training-Institution-Address","className":"col-md-6","subtype":"text"},{"type":"checkbox-group","label":"Did you graduate / receive certification?","inline":true,"name":"Did-you-graduate--receive-certification","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"text","label":"Other Graduation / Certification Year","name":"Other-Graduation--Certification-Year","className":"col-md-6","subtype":"text"},{"type":"text","label":"Degree / Certification Obtained","name":"Degree--Certification-Obtained","className":"d-block","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Employment History <div>(Present to Past)</div>","className":"d-block"},{"type":"text","required":true,"label":"1 Company Name","name":"1-Company-Name","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"1 Company Phone Number","name":"1-Company-Phone-Number","className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"1 Company Address","name":"1-Company-Address","className":"d-block","subtype":"text"},{"type":"text","required":true,"label":"1 Job Title","name":"1-Job-Title","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"1 Supervisor","name":"1-Supervisor","className":"col-md-6","subtype":"text"},{"type":"date","required":true,"label":"1 Start Date","name":"1-Start-Date","className":"col-md-6 col-lg-3"},{"type":"date","required":true,"label":"1 End Date","name":"1-End-Date","className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"1 Starting Salary","name":"1-Starting-Salary","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"1 Ending Salary","name":"1-Ending-Salary","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"textarea","required":true,"label":"1 Responsibilities","name":"1-Responsibilities","subtype":"textarea","rows":5,"className":"d-block"},{"type":"textarea","required":true,"label":"1 What was your reason for leaving?","name":"1-What-was-your-reason-for-leaving","subtype":"textarea","rows":2,"className":"d-block"},{"type":"checkbox-group","required":true,"label":"1 May we contact your previous employer for a reference?","inline":true,"name":"1-May-we-contact-your-previous-employer-for-a-reference","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"text","label":"2 Company Name","name":"2-Company-Name","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","label":"2 Company Phone Number","name":"2-Company-Phone-Number","className":"col-md-6 col-lg-3"},{"type":"text","label":"2 Company Address","name":"2-Company-Address","className":"d-block","subtype":"text"},{"type":"text","label":"2 Job Title","name":"2-Job-Title","className":"col-md-6","subtype":"text"},{"type":"text","label":"2 Supervisor","name":"2-Supervisor","className":"col-md-6","subtype":"text"},{"type":"date","label":"2 Start Date","name":"2-Start-Date","className":"col-md-6 col-lg-3"},{"type":"date","label":"2 End Date","name":"2-End-Date","className":"col-md-6 col-lg-3"},{"type":"text","label":"2 Starting Salary","name":"2-Starting-Salary","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"2 Ending Salary","name":"2-Ending-Salary","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"textarea","label":"2 Responsibilities","name":"2-Responsibilities","subtype":"textarea","rows":5,"className":"d-block"},{"type":"textarea","label":"2 What was your reason for leaving?","name":"2-What-was-your-reason-for-leaving","subtype":"textarea","maxlength":2,"className":"d-block"},{"type":"checkbox-group","label":"2 May we contact your previous employer for a reference? ","inline":true,"name":"2-May-we-contact-your-previous-employer-for-a-reference-","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"text","label":"3 Company Name","name":"3-Company-Name","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","label":"3 Company Phone Number","name":"3-Company-Phone-Number","className":"col-md-6 col-lg-3"},{"type":"text","label":"3 Company Address","name":"3-Company-Address","className":"d-block","subtype":"text"},{"type":"text","label":"3 Job Title","name":"3-Job-Title","className":"col-md-6","subtype":"text"},{"type":"text","label":"3 Supervisor","name":"3-Supervisor","className":"col-md-6","subtype":"text"},{"type":"date","label":"3 Start Date","name":"3-Start-Date","className":"col-md-6 col-lg-3"},{"type":"date","label":"3 End Date","name":"3-End-Date","className":"col-md-6 col-lg-3"},{"type":"text","label":"3 Starting Salary","name":"3-Starting-Salary","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"3 Ending Salary","name":"3-Ending-Salary","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"textarea","label":"3 Responsibilities ","name":"3-Responsibilities-","subtype":"textarea","rows":5,"className":"d-block"},{"type":"textarea","label":"3 What was your reason for leaving?","name":"3-What-was-your-reason-for-leaving","subtype":"textarea","rows":2,"className":"d-block"},{"type":"checkbox-group","label":"3 May we contact your previous employer for a reference?","inline":true,"name":"3-May-we-contact-your-previous-employer-for-a-reference","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Military Service","className":"d-block"},{"type":"text","label":"Branch","name":"Branch","className":"col-lg-4","subtype":"text"},{"type":"date","label":"Enlistment Date","name":"Enlistment-Date","className":"col-lg-4"},{"type":"date","label":"Separation Date","name":"Separation-Date","className":"col-lg-4"},{"type":"text","label":"Type of Discharge","name":"Type-of-Discharge","className":"col-md-6","subtype":"text"},{"type":"text","label":"Rank at Discharge","name":"Rank-at-Discharge","className":"col-md-6","subtype":"text"},{"type":"textarea","label":"If other than honorable discharge, explain:","name":"If-other-than-honorable-discharge-explain","subtype":"textarea","rows":5,"className":"d-block"},{"type":"textarea","label":"List any serious offenses for which you were disciplined while serving in the military. ","name":"List-any-serious-offenses-for-which-you-were-disciplined-while-serving-in-the-military-","subtype":"textarea","maxlength":5,"className":"d-block"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"References <div>(Must not be related to the applicant & not listed in Employment History as a previous supervisor.)</div>","className":"d-block"},{"type":"text","required":true,"label":"Reference 1 Name","name":"Reference-1-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"How are you acquainted with Reference 1?","name":"How-are-you-acquainted-with-Reference-1","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference 1 Company","name":"Reference-1-Company","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"Reference 1 Phone Number","name":"Reference-1-Phone-Number","className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"text","required":true,"label":"Reference 2 Name","name":"Reference-2-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"How are you acquainted with Reference 2?","name":"How-are-you-acquainted-with-Reference-2","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference 2 Company","name":"Reference-2-Company","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"Reference 2 Phone Number","name":"Reference-2-Phone-Number","className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"text","required":true,"label":"Reference 3 Name","name":"Reference-3-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"How are you acquainted with Reference 3?","name":"How-are-you-acquainted-with-Reference-3","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference 3 Company","name":"Reference-3-Company","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"Reference 3 Phone Number","name":"Reference-3-Phone-Number","className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"textarea","label":"<span style=\"font-weight: bolder; color: rgb(0, 0, 0); font-family: Roboto, sans-serif; font-size: 16px;\"><span times=\"\" new=\"\" roman\";mso-hansi-font-family:calibri;=\"\" mso-bidi-font-family:calibri;color:black\"=\"\" style=\"font-size: 12pt; line-height: 24px;\">This section can be used to add any additional information that may be beneficial in evaluating your application.</span></span>","name":"This-section-can-be-used-to-add-any-additional-information-that-may-be-beneficial-in-evaluating-your-application","subtype":"textarea","rows":5,"className":"d-block"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div class=\"d-block\" style=\"flex-shrink: 0; width: 1380px; max-width: 100%; padding-right: calc(var(--bs-gutter-x)*.5); padding-left: calc(var(--bs-gutter-x)*.5); margin-top: var(--bs-gutter-y); color: rgb(0, 0, 0); font-family: Roboto, sans-serif; font-size: 16px;\"><p style=\"margin-bottom: 1rem; font-weight: bold; font-size: 1.8em;\"><span style=\"font-size: 1.8em; text-align: var(--bs-body-text-align);\">DISCLAIMER</span><br></p></div><p class=\"d-block\" id=\"control-7372692\" style=\"margin-top: var(--bs-gutter-y); margin-bottom: 1rem; flex-shrink: 0; width: 1380px; max-width: 100%; padding-right: calc(var(--bs-gutter-x)*.5); padding-left: calc(var(--bs-gutter-x)*.5); color: rgb(0, 0, 0); font-family: Roboto, sans-serif; font-size: 16px;\"></p><p class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"><span style=\"font-weight: bolder;\"><span times=\"\" new=\"\" roman\";mso-hansi-font-family:calibri;mso-bidi-font-family:calibri;=\"\" color:black\"=\"\" style=\"font-size: 16pt;\">If hired, I will conform to the rules and regulations of Caldwell County and my employment and compensations can be terminated with or without cause and with or without notice at any time at the option of either Caldwell County or myself. I understand that no representative of Caldwell County has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to this disclaimer.<o:p></o:p></span></span></p><p class=\"MsoNoSpacing\" style=\"margin-bottom: 1rem;\"><span style=\"font-weight: bolder;\"><span style=\"font-size: 16pt;\"> </span></span></p><p class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"><span style=\"font-weight: bolder;\"><span times=\"\" new=\"\" roman\";mso-hansi-font-family:calibri;mso-bidi-font-family:calibri;=\"\" color:black\"=\"\" style=\"font-size: 16pt;\">I hereby attest that I have completed this application to the best of my ability and that all facts are true to my knowledge. I understand that any misstatement or omission may result in my termination. I hereby authorize you to verify the information that I have set forth in this application and authorize you to communicate with any reference or prior employers, except as noted.<o:p></o:p></span></span></p><p class=\"MsoNoSpacing\" style=\"margin-bottom: 1rem;\"><span style=\"font-weight: bolder;\"><span style=\"font-size: 16pt;\"> </span></span></p><p class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"><span style=\"font-weight: bolder;\"><span times=\"\" new=\"\" roman\";mso-hansi-font-family:calibri;mso-bidi-font-family:calibri;=\"\" color:black\"=\"\" style=\"font-size: 16pt;\">I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.<o:p></o:p></span></span></p><p class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"><span style=\"font-weight: bolder;\"><span times=\"\" new=\"\" roman\";mso-bidi-font-family:=\"\" calibri;mso-bidi-theme-font:minor-latin;color:black\"=\"\" style=\"font-size: 16pt;\"> </span></span></p><p class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"></p><p class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"><font color=\"#000000\"><span style=\"font-size: 21.3333px;\"><b>By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application. </b></span></font></p><p></p>","className":"d-block"},{"type":"text","label":"<span style=\"font-size: 14px;\">Type Name Here for Electronic Signature</span>","name":"Type-Name-Here-for-Electronic-Signature","className":"col-md-6","subtype":"text"},{"type":"date","required":true,"label":"Date","name":"Date","className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"file","label":"Please select one or more files for upload. You may upload up to 20 files (35 Mb max). Files can be PDF, JPG, JPEG format. To upload multiple files, please hold control while clicking on multiple files before clicking \"Open\".","description":"Use this to submit resume, certificates, diplomas, etc.","name":"File-Upload","subtype":"file","multiple":true,"className":"d-block"}]