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Become An Officer Form
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-
Step
1
of 9
General Information
First Name
*
Middle Name
Last Name
*
Date of Birth
*
Social Security #
*
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Home Phone
*
Business Phone
Email
*
Type of Work or Position Applied For
*
SLEO 1
SLEO 2
Police Officer
Next
Legal Information
Are you 18 years of age or older?
*
Yes
No
Are you eligible for employment in the U.S.?
*
Yes
No
Do you possess a driver's license that is valid in New Jersey?
*
Yes
No
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?
*
Yes
No
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?
*
Yes
No
If yes, specify...
*
Previous
Next
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)
To
Major Area of Study
Type of Degree
Did you graduate?
Yes
No
School 2
Name & Location
Date Attended (start date)
From
Date Attended (end date)
To
Major Area of Study
Type of Degree
Did you graduate?
Yes
No
School 3
Name & Location
Date Attended (start date)
From
Date Attended (end date)
To
Major Area of Study
Type of Degree
Did you graduate?
Yes
No
School 4
Name & Location
Date Attended (start date)
From
Date Attended (end date)
To
Major Area of Study
Type of Degree
Did you graduate?
Yes
No
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Next
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)
To
Subjects or Courses
Was the course completed?
Yes
No
School 2
Name & Location
Date Attended (start date)
From
Date Attended (end date)
To
Subjects or Courses
Was the course completed?
Yes
No
School 3
Name & Location
Date Attended (start date)
From
Date Attended (end date)
To
Subjects or Courses
Was the course completed?
Yes
No
School 4
Name & Location
Date Attended (start date)
From
Date Attended (end date)
To
Subjects or Courses
Was the course completed?
Yes
No
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.
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Next
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
To
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
To
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
To
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
Previous
Next
Do you have any objection to our contacting any employers listed on the previous page regarding your employment?
Yes
No
If yes, explain...
Are you engaged in other business activity or employment which you desire to continue if employed by the County of Camden?
Yes
No
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?
Yes
No
If yes, explain
Do you have any relatives who work for the county?
Yes
No
If yes, please list the name of relative and their position
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Next
References
First Reference
Name
*
First
Last
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
*
Occupation
*
Second Reference
Name
*
First
Last
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
*
Occupation
*
Third Reference
Name
*
First
Last
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
*
Occupation
*
Previous
Next
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)
Previous
Next
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
*
Submit