Become An Officer Form - Camden County Police Department

General Information

First Name *

Middle Name

Last Name *

Date of Birth *

Social Security # *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone *

Business Phone

Email *

Type of Work or Position Applied For *

Legal Information

Are you 18 years of age or older? *

Are you eligible for employment in the U.S.? *

Do you possess a driver's license that is valid in New Jersey? *

Answer this question only if it is a requirement as indicated in the job announcement

Drivers License Number *

Have you ever worked or been educated under a different name? *

Answer this question only if it is a requirement as indicated in the job announcement

If yes, specify...

Have you ever worked for the count of Camden before? *

If yes, specify... *

High School, GED, College and Graduate Schools

List any high school or equivelant, college, universities, and graduate schools which you have attended.

School 1

Name & Location

Date Attended (start date)

From

Date Attended (end date)

Major Area of Study

Type of Degree

Did you graduate?

School 2

Name & Location

Date Attended (start date)

From

Date Attended (end date)

Major Area of Study

Type of Degree

Did you graduate?

School 3

Name & Location

Date Attended (start date)

From

Date Attended (end date)

Major Area of Study

Type of Degree

Did you graduate?

School 4

Name & Location

Date Attended (start date)

From

Date Attended (end date)

Major Area of Study

Type of Degree

Did you graduate?

Other Schools or Training Schools

Include business, vocational, technical, and other schools you have attended that are related to the title for which you are applying. If it is not a full curriculum, be specific as to the number of hours.

School 1

Name & Location

Date Attended (start date)

From

Date Attended (end date)

Subjects or Courses

Was the course completed?

School 2

Name & Location

Date Attended (start date)

From

Date Attended (end date)

Subjects or Courses

Was the course completed?

School 3

Name & Location

Date Attended (start date)

From

Date Attended (end date)

Subjects or Courses

Was the course completed?

School 4

Name & Location

Date Attended (start date)

From

Date Attended (end date)

Subjects or Courses

Was the course completed?

Additional Education

Use this space to describe any licenses, certificates, registrations, skills, crafts, including machines or equipment operated which relates to the position for which you are applying.

List All Employment

Start with present or last position and work back. Include U.S. Military and volunteer experience. Please complete in full even though you may attach a resume.

Position 1

Position Title

Start Date

From

End Date

Starting Salary

Ending Salary

Employer's Name & Address

Supervisor's Name

First

Last

Employer's Phone Number

Type of Position

Full-Time
Part-Time
Seasonal/Temporary

Hours Per Week

Reason for Leaving

Description of Duties

Position 2

Position Title

Start Date

From

End Date

Starting Salary

Ending Salary

Employer's Name & Address

Supervisor's Name

First

Last

Employer's Phone Number

Type of Position

Full-Time
Part-Time
Seasonal/Temporary

Hours Per Week

Reason for Leaving

Description of Duties

Position 3

Position Title

Start Date

From

End Date

Starting Salary

Ending Salary

Employer's Name & Address

Supervisor's Name

First

Last

Employer's Phone Number

Type of Position

Full-Time
Part-Time
Seasonal/Temporary

Hours Per Week

Reason for Leaving

Description of Duties

Do you have any objection to our contacting any employers listed on the previous page regarding your employment?

If yes, explain...

Are you engaged in other business activity or employment which you desire to continue if employed by the County of Camden?

If yes, explain...

Do you or does a member of your immediate own or have an interest in any organization that deals with, is regulated by, or is otherwise affected by the operations of any department of the County of Camden?

If yes, explain

Do you have any relatives who work for the county?

If yes, please list the name of relative and their position

References

First Reference

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Occupation *

Second Reference

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Occupation *

Third Reference

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Occupation *

Emergency Contact Information

Name *

First

Last

Phone *

How did you hear about the job? (Select all that apply) *

Social Media
LinkedIn
Peer Referral
Job/Career Fair
Word of mouth
Advertisements
School Job Board
Third-Party Review
Google/Search Engine
Other

Please Specify (optional)

Applicant Date and Sign

I hereby certify that there is no misrepresentation or falsification in the information stated in this application. I am aware that false or misleading statements will be cause for rejection or dismissal after employment.

Virtual Signature (First/Last) *

Today's Date *

Email *