HPD Personal History Questionnaire
  • Personal History Questionnaire

    Homewood Police Department
  • Format: (000) 000-0000.
  • Are you at least 18 years old?
  • Are you at a legal citizen of the United States?
  • Are you presently using illegal drugs?
  • Have you ever possessed or sold any amount of illegal drugs?
  • Do you consume alcohol?
  • Are you an honest person?
  • Are you reliable?
  • Are you able to manage your personal finances?
  • Are you good at communicating with all kinds of people?
  • Are you able to control your anger when insulted or threatened?
  • Are you able to function normally when placed under temporary or prolonged stress?
  • Do you have any outstanding civil judgements?
  • Have you committed an illegal act in the last 5 years?
  • Have you ever been detained by the police?
  • Have you ever been arrested?
  • Have you ever been convicted of a crime?
  • Have you ever been convicted of a felony?
  • List all arrests for which you have been convicted of, including traffic arrests:

  • Have you have any relatives who have criminal convictions?
  • Are you willing to work rotating shifts?
  • Are you willing to work overtime with little or no notice?
  • Are you willing to work holidays and weekends?
  • Are you willing to wear a uniform?
  • Are you willing to conform to department grooming standards?
  • Can you perform the essential job functions of the job applied for, with or without reasonable accommodations? (Essential job functions list can be viewed at the personnel board of Jefferson County website – pbjcal.org.)
  • Military Service

  • Have you ever served in a military organization?
  • You can move to the next page.

  • Start date of service
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  • End date of service
     - -
  • Was your discharge honorable?
  • Did you have any convictions under uniform code of military justice (UCMJ)?
  • Did you receive any disciplinary actions under UCMJ?
  • Are you presently a member of the national guard or reserve?
  • Residence History

  • Rows
  • Employment History

  • Have you ever applied for employment with any other police agency?
  • Have you been interviewed and then rejected by any of the departments listed?
  • Were you ever discharged, forced to resign, or under investigation for the following reasons?
  • For which reason(s) (Choose all that apply)
  • Have you received any disciplinary actions from an employer?
  • List all jobs you have had in the last ten years. Include periods of unemployment. Put your present or most recent job first. Include military service in proper sequence and all temporary or part-time jobs.

  • First Job
  • Start Date
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  • End Date
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  • Start Date
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  • End Date
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  • Start Date
     - -
  • End Date
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  • Start Date
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  • End Date
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  • Start Date
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  • End Date
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  • Start Date
     - -
  • End Date
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  • Start Date
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  • End Date
     - -
  • Education

    Provide the information requested below concerning high schools you have attended.
  • Choose One
  • Start Date
     - -
  • End Date
     - -
  • Did you graduate from this school?
  • Start Date
     - -
  • End Date
     - -
  • Did you graduate from this school?
  • Start Date
     - -
  • End Date
     - -
  • Did you graduate from this school?
  • Choose One
  • Start Date
     - -
  • End Date
     - -
  • Did you graduate from this school?
  • Start Date
     - -
  • End Date
     - -
  • Did you graduate from this school?
  • Start Date
     - -
  • End Date
     - -
  • Did you graduate from this school?
  • Personal References

    3 are required
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Interview Questionnaire

  • Do you know sign language?
  • Are you color blind?
  • Are you applying to be a police or corrections officer?
  • You can go to the next section.

  • Are you 21 years of age or older?
  • Do you possess a valid alabama driver’s license?
  • Has your license ever been suspended or revoked?
  • Have you ever held a drivers license in another state?
  • Was this license ever suspended or revoked?
  • Are you willing to use deadly physical force, if necessary, to protect your life or that of another person?
  • Are you able and willing to render emergency aid to trauma victims?
  • Are you able and willing to identify deceased persons and witness autopsies?
  • With proper training and supervision, and/or the provision of reasonable accommodation, can you perform all of the essential job functions of a law enforcement officer without delay?
  • Should be Empty: