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Sheriff Office Employment Form


    We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.

    If you are under 18 years of age, can you provide proof of your eligibility to work?

    Have you ever been employed with us before?

    Are you currently employed?

    May we contact your present employer?

    On what date would you be able for work?

    Are you available to work:

    Applicants are considered for all positions, and employees are treated during without regard to race, color, religion sex, national origin, age, marital or veteran status, medical condition or handicap.

    As employers, we comply with government record-keeping, reporting and other legal requirements, please fill out the applicant data record. We appreciate your cooperation.

    This data is for periodic government reporting and will be kept in a confidential file.

    Are you available to work:

    Are you prevented from lawfully becoming employed in the country because of Visa or Immigration Status?

    Have you been convicted of a felony with in the last 7 years?

    Conviction will not necessarily disqualify an applicant from employment.

    Applicant Data Record

    Government agencies require periodic reports on the sex, ethnicity, handicapped, and veteran status of applicants. This data is for analysis and affirmative action only. Submission of information about a handicap is voluntary.

    CHECK ONE:

    CHECK IF ANY OF THE FOLLOWING ARE APPLICABLE:

    EDUCATION

    Elementary School

    High School

    Undergraduate School

    Graduate School

    Other School

    Indicate any foreign languages you can speak, read and/or write.

    Employment Experiences

    Start with your present or last job. Include any job-related military services assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

    List professional, trade, business or civic activities and offices held. You may exclude membership which would reveal gender, race, religion, national origin, age ancestry, disability or other protected status:

    Other Qualifications

    Summarized special job-related skills, and qualifications, licenses or certifications acquired from employment, training, education or other experience. Acquired from employment, training, education or other experience.

    State any additional information you feel may be helpful to us in considering your application.

    Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

    Are you capable of performing in a reasonable manner the activities involved in the job occupation for which you have applied?

    References

    Applicant's Statement

    I certify that the answers given herein are true and complete to the best of my knowledge.

    I authorize investigation of all statements contained in the application for employment as may be necessary in arriving at an employment decision.

    This application for employment will remain active if applicant meets all the requirements for eligibility as set forth by the Union County Sheriff's Office Merit Board standards. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

    I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will nature, which means that the Employee may resign at any time and the Employer may discharge an Employee at any time or without cause. It is further understood that this "at will" employment relationship may not be charged by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

    You must furnish with this application of a copy of each of the following documents, if applicable to you:

    Birth Certificate

    Social Security Card

    High Scholl Diploma/G.E.D. Certificate

    College or University Diploma/Certification

    Military Service Record

    Military Discharge Papers

    CRIMINAL BACKGROUND INVESTIGATION RELEASE FORM

    Please read this form carefully and be aware that by allowing the Union County Sheriff's Office to investigate your background with the authorized entities you will be waiving and releasing all claims for damages you might sustain arising out of the criminal background check and review.

    I understand that a successful criminal background investigation is a condition of my employment or with the Union County Sheriff's Office.

    I agree to waive and relinquish all claims I may have against the Union County Sheriff's Office, its officers, agents, servants, and the employees from any and all claims from damages which I may have or which may accrue to me on account of the results of any aspect of the criminal background investigation.

    I do hereby fully release and discharge the Union County Sheriff's Office, its respective officers, agents, servants and
    employees from any and all claims from damages which I may have or which may accrue to me on account of the results of any aspect of the criminal background investigation.

    I further agree to indemnify and hold harmless and defend the Union County Sheriff's Office, its respective officers, agents, servants and employees from any and all claims resulting from damages sustained by me or arising out of, connected with, or in any way associated with, any if the activities of the criminal background investigation and review. I also understand that a criminal charge or a criminal conviction will not automatically exclude me from the employment I am seeking. However, a false answer or refusal to answer on the application or refusal to sign this release is automatic grounds for exclusion from the job I am applying for.

    I have read and fully understand this Waiver and Release of All Claims.

    APTITUDE TEST

    Please read this form carefully and be aware that by allowing the Union County Sheriff's Office to perform a physical aptitude test you will be waiving and releasing all claims for damages you might sustain arising out of the examination of and performance resulting from the physical aptitude test. I understand that I may be subject to a physical Aptitude Test as a condition of my employment with the Union County Sheriff's Office.

    I understand that during the Physical Aptitude Test I will be asked to perform various physical activities that will test and challenge my strength, endurance and overall health. I understand that during the performance of the Physical Aptitude Test that certain physical elements of my body will be taxed, including my oxygen, heart rate, blood pressure, muscle and joint strength. By signing this form, I acknowledge and affirmatively state that I am not under any doctor's restriction or limitation; nor am I suffering from any ailment or condition that would limit my ability to perform the Physical Aptitude Test.

    I also state that I understand that if I have any concerns or questions about my ability to perform any physically strenuous and challenging task that I have ample time to avail myself to a proper physician for an examination to determine whether I should also be so restricted. If I do avail myself to such an examination I will promptly notify the Union County Sheriff's Office if I am not able to perform the Physical Agility Test.

    Having knowledge of and having acknowledged the foregoing, I agree to waive and relinquish all claims I may have against the Union County Sheriff's Office, or their officers, agents, servants, and employees as a result of my participation in the Physical Aptitude Test.

    I do hereby fully release and discharge the Union County Sheriff's Office, their respective officers, agents, servants and employees from any and all claims from damages which I may have or which may accrue to me on account of my participation in the Physical Aptitude Test.

    I have read and fully understand this Physical Aptitude Release Form.


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