As an applicant for a position with the Cloverdale Police Department (the Department), you may be asked to submit to a complete background check of criminal, civil history; required to complete a polygraph examination); credit/financial-responsibility history. You may also be asked to submit to a complete 3rd party health physical and/or mental evaluation, as they relate to job performance requirements. You may also be asked to complete a medical waiver and meet physical fitness requirements (testing) as they relate to job performance.
Any false, misrepresented or fictious information provided may cause you to be removed from further consideration regarding a position or employment with the Cloverdale Police Department.
Acceptance of this application does not constitute an offer of employment or a position with the Cloverdale Police Department.
To determine your eligibility for a position with Cloverdale Police Department, please answer the following questions truthfully and as accurately as possible:
As an applicant, I understand that all information provided may be verified as noted previously.
Please review carefully and correct your e-mail address, if needed! Failure to do so may result in a lost opportunity!
An-and-all references may be contacted as part of the background investigation. Please make sure contact information is accurate.
NOTE: Mutilation is defined under current Department policy as a purposeful, knowing, or intentional disfigurement, modification, or alteration of one’s natural appearance that could bring discredit to the Department or create a non-uniform appearance which might hinder Department esprit de corps. Such mutilations may include, but are not limited to brands, ear gauges, nose gauges, facial piercings, tongue trimming, tongue splitting, tongue studs, cranium cosmetic implants or any other implant that does not project an anthropomorphic appearance.
If “Yes”, complete the following information:
Below, list ALL law enforcement experience, beginning with the most recent:
MILITARY SERVICE AND STATUS
Include active-duty service with the National Guard and Reserve Components.
If “Yes”, complete the information below for each branch of service, beginning with the most recent:
Employment history will be verified
List current and past employment-beginning with the most recent (include part-time less than 20 hours per week):
DRIVER INFORMATION & HISTORY
List current issued driver’s license information below: (List all current license)
If “Yes”, complete the information requested below for each offense, beginning with the most recent:
To avoid nepotism during the interview process, it is necessary that you notify the Department of all relatives who have or currently work for the Cloverdale Police Department in the spaces provided below. For purposes of this procedure, “relative” means father, mother, brother, sister, uncle, aunt, husband, wife, son, daughter, son-in-law, daughter-in-law, niece, or nephew.
If “Yes”, enter their information below:
MISCELLANEOUS INFORMATION/ DETAILS
SUPPLEMENTAL / ADDITIONAL INFORMATION
If you answered “Yes” to any questions above or would like to explain further, please use the space provided below or you may attach a separate document(s):
By placing my name in the box below, I swear or affirm under the penalty of perjury, all information contained in this application is true, accurate and complete to the best of my knowledge. I understand any false information provided may cause me to be removed from further consideration for a position with the Cloverdale Police Department.