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2. Date
   Date
4. First Name*
5. Last Name*
7. Address*
9. City
10. State
11. Zip
13. Telephone Number
14. Email Address*
15. Best time to contact you

    1. Day
    2. Evening
    3. Doesn't matter
17. Position you are interested in:*

    1. Detention Officer
    2. Deputy Sheriff
    3. School Resource Officer
    4. Internship
    5. Ride Along
18. Are you currently Detention Officer Certified?

    1. Yes
    2. No
19. Are you currently BLET Certified?

    1. Yes
    2. No
21. Are you at least 20 years of age?*

    1. Yes
    2. No
22. Are you a military veteran?

    1. Yes
    2. No
23. If you are a veteran, list the Branch and years served.
25. Driver's License Number*
26. Driver's License State*
28. List any criminal charges that you have had including traffic citations.*
30. Have you used any type of narcotics or drugs in the last two years?*
32. Are you currently employed?

    1. Yes
    2. No
33. Current job title*
34. State name of business where employed*
36. Have you ever been fired, terminated, or asked to resign by an employer?

    1. Yes
    2. No
37. How did you hear about our recruiting efforts?

    1. Indeed.com
    2. Governmentjobs.com
    3. ZipRecruiter.com
    4. Current Employee
    5. Career Fair
    6. Other
40. If OTHER, please list how you heard about our recruiting efforts.
42. If referred by current employee, please list employee name.
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field