UNIVERSITY POLICE

POLICE SUBMENU

Campus Student Officer Application

    NAME AND CONTACT INFORMATION
     
    First, Middle, Last Name
     
    Date of Birth S.S. Number
     
    Contact Number Other Number
     
    Email
     
    Home Address
     
    City, State, Zip
     
    School/Local Address, City State, Zip(if different from Home Address)

     
    Do you posses a valid driver's license (answering "No" does not disqualify you from being hired)
    If yes, D.L. Number D.L. State
     
     

    SCHOOL INFORMATION
     
    Are you a current student?
     
    Undergraduate Status Major
     
     

    ANSWER ALL QUESTIONS IN THIS SECTION
     
    Have you ever been arrested or convicted for any crime other than minor traffic violation?

     
    Have you ever been fired or asked to resign from a job

     
    Have you ever been on probation?

     
    Do you now or have you ever used any illegal substances? (marijuana, cocaine, methamphetamine, heroin, LSD, Ecstasy, etc.)

    If you answered YES to any of the above questions, please explain below.

     

    MILITARY SERVICE
     
    Have You Served in the Military?
     

     National Guard

              Reserves

                 Active
     
    Served From To Branch
     
    MOS/ Job Description
     
    Discharged If yes, was discharge HONORABLE
     
     

    WORK EXPERIENCE
    Last Job Held
     
    Employer, Address, City, State

     
    Job Title, Reason For Leaving

     
    Dates of Employment (mm/dd/yyyy) to (mm/dd/yyyy) and Name of Superviosr

     
    Other Work Experience You Would Like To Tell Us About

     
     

    SKILLS AND ABILITIES
     
    Skills and Abilities Tell us about any special skills or abilities you possess

     
    Comments Is there anything else you would like us to know?

     

    I certify that the information I provided on this application is true and correct to the best of my knowledge.