2026 F3

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Telecommunicator
Citizenship - US Born
Deputy
Detention Officer
Have you previously submitted an application for employment with this agency
Yes
Citizenship - US Naturalized
Home School
Did not Attend
Traditional
Distance Learning
Home School0
Other
undefined_24
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Widowed
Divorced
Never Married
Married
Separated
Engaged
Children - No
Children - Yes
Supporting Children - No
Supporting Children - Yes
Supporting Children - N/A
Not Related to person at Agency
Related to person at Agency
26 Have you ever been denied employment by a criminal justice agency after a conditional offer of
Commission Board or Agency established to certify or license that position Note List any such
27b If such certification or license was ever suspended revoked and any sanctions taken against it by
Yes_16
No If Yes list employer timeframe and reason
Yes_17
No If YES complete 31 through 38 If NO skip to 39
Honor No
Under oth no
Unchar
Unchar No
Honor Yes
General
General no
Under oth
Bad conduct
Bad conduct no
Dishon
Dishon no
Dismis
Dismis no
captains mast company punishment article 15 written reprimand andor any other disciplinary action while a
Do you drink alcohol?
Q32 Y or N
Q33 Y or N
Q34 Y or N
Q35 Y or N
Have you ever been arrested or charged?
More pages attached
Ever been on probation?
Legal Firearm Possession Circumstances
NOTE In question 39 the word drink means one time or more including experimentation15
NOTE In question 39 the word drink means one time or more including experimentation22
License in any other state
License ever revoked?
x

Additional Signatures Required