UCPD Employment Application
Each answer must be answered when applicable. If not, indicate N/A (not applicable).
Applicant Information
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Phone Number
Please enter a valid phone number.
Social Security #
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Are you a citizen of the United States?
Yes
No
If not a citizen, are you authorized to work in the United States?
Yes
No
Do you currently have driving privileges in Ohio?
Yes
No
Have your driving privileges ever been suspended?
Yes
No
Have you ever worked for University Circle Incorporated?
Yes
No
Do you currently have any relatives that work for University Circle Incorporated?
Yes
No
Have you ever been bonded?
Yes
No
Have you ever been refused a bond?
Yes
No
Have you ever been convicted of a felony?
Yes
No
If yes, explain:
How did you learn of this opening?
Position applying for:
Date available to start:
-
Month
-
Day
Year
Date
Education
Name of School
Location
Years Completed
Degree or Major
1
2
3
Military Service
Branch
From
-
Month
-
Day
Year
Date
To
-
Month
-
Day
Year
Date
Rank at Discharge
Type of Discharge
If discharge was other than honorable, explain
Specialties or Duties
Have you ever applied for a position with any government agency, police or fire department?
Department
Position Applied For
Hired: Yes/No/Pending
1
2
3
Work History
List previous employers starting with current or most recent employer first.
Company
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Supervisor's Name
First Name
Last Name
Job Title
Start Salary
End Salary
From
-
Month
-
Day
Year
Date
To
-
Month
-
Day
Year
Date
Reason for leaving
Responsibilities
Company
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Supervisor's Name
First Name
Last Name
Job Title
Start Salary
End Salary
From
-
Month
-
Day
Year
Date
To
-
Month
-
Day
Year
Date
Reason for leaving
Responsibilities
Company
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Supervisor's Name
First Name
Last Name
Job Title
Start Salary
End Salary
From
-
Month
-
Day
Year
Date
To
-
Month
-
Day
Year
Date
Reason for leaving
Responsibilities
Disclaimer
I certify that my answers are true and complete to the best of my knowledge. I understand that nothing in this application creates an employment promise or contract between me and University Circle Inc. (UCI). If I am hired by UCI, my employment and compensation will be “at will,” which means that my employment can be terminated by UCI or by me, with or without cause, with or without notice. Any exception to this rule must be in writing and signed by an officer of UCI to be valid. UCI may make a thorough background investigation of my work and personal history and may verify all information I give in my application, related paperwork, or interviews. I hereby authorize UCI to investigate my records, including references, medical, school, credit, employment, criminal and court records, and waive my claims against those giving information to UCI that is true or given in good faith. If this application leads to employment, I understand that false or misleading information in my application or interview may result in the termination of my employment. I also understand that I am required to follow all rules and regulations of UCI during my employment, or I may be disciplined up to and including discharge.
Signature
Date
-
Month
-
Day
Year
Date
Non-Discrimination Statement
IN ACCORDANCE WITH APPLICABLE FEDERAL, STATE AND LOCAL LAW, THE UNIVERSITY CIRCLE POLICE DEPARTMENT PROVIDES EQUAL OPPORTUNITIES FOR APPLICANTS AND EMPLOYEES, REGARDLESS OFRACE, GENDER EXPRESSION, AGE, PREGNANCY, RELIGION, CREED, COLOR, NATIONAL ORIGIN, ANCESTRY, PHYSICAL OR MENTAL HANDICAP, GENETIC INFORMATION, VETERAN STATUS, MARITAL STATUS, SEX OR ANY OTHER PROTECTED CLASS OR STATUS. THE DEPARTMENT DOES NOT SHOW PARTIALITY OR GRANT ANY SPECIAL STATUS TO ANY APPLICANT, EMPLOYEE OR GROUP OF EMPLOYEES UNLESS OTHERWISE REQUIRED BY LAW. THE DEPARTMENT WILL RECRUIT AND HIRE ONLY THOSE INDIVIDUALS WHO DEMONSTRATE ACOMMITMENT TO SERVICE AND WHO POSSESS THE TRAITS AND CHARACTERISTICS THAT REFLECT PERSONAL INTEGRITY AND HIGH ETHICAL STANDARDS.
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