LA CRESCENT POLICE DEPARTMENT
Application for Employment
TO THE APPLICANT:
We appreciate your interest in seeking employment with the City of La Crescent. Completing this application will assist us in understanding your work history and education background. The City of La Crescent is an Equal Opportunity/Affirmative Action employer. The City follows the principles of non-discrimination in employment, complying with all federal, state and local laws and requires all City employees to comply with such laws. A SEPARATE APPLICATION MUST BE COMPLETED FOR EACH POSITION. REVIEW THE QUALIFICATION REQUIREMENTS CAREFULLY. Applications are accepted only for the job posted and MUST BE SUBMITTED by the closing date.
Position Applying For
*
Please Select
Peace Officer
Peace Officer (Part-Time)
Police Reserve Officer
Internship
Date of Application
*
/
Month
/
Day
Year
Date
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Do you currently hold a valid POST license?
*
Yes
No
No, but I am currently eligible to be licensed
No, but I am currently enrolled in a POST approved Peace Officer Education Program
Please enter your POST license number if applicable. If you are not currently POST licensed or POST eligible, please enter the date you expect to be eligible:
Back
Next
Education History
Have you graduated from High School or Received a GED?
*
Yes
No
Name of High School
*
Have you attended any Post-Secondary Education institutions? Include technical colleges, universities, trade schools, professional schools, etc.
*
Yes
No
Post-Secondary School (Most Recent)
School Name
Program
City
State / Province
Degree and Graduation Date (or estimated graduation date)
Post-Secondary School
School Name
Program
City
State / Province
Degree and Graduation Date (or estimated graduation date)
Post-Secondary School
School Name
Program
City
State / Province
Degree and Graduation Date (or estimated graduation date)
Post-Secondary School
School Name
Program
City
State / Province
Degree and Graduation Date (or estimated graduation date)
Back
Next
Special Skills/Licenses
List skills you possess which are required for the job as stated in the job announcement, such as driver's license (give type and number) ability to operate specialized machinery or equipment, or professional registration or licensing. Indicate any training you have had which is directly related to the job for which you are applying.
Back
Next
Employment History
PLEASE GIVE ACCURATE, COMPLETE, FULL-TIME AND PART-TIME RECORD. START WITH PRESENT OR MOST RECENT EMPLOYER. BE COMPLETE. Experience and training ratings are determined by the information you provide and your score is based upon it. DO NOT MARK APPLICATION "SEE RESUME". Account for ALL your work and include volunteer experience.
Employment (current or most recent)
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Employment
Company/Employer Name and Location (city, state)
Position/Title
Phone
Dates of Employment
Direct Supervisor Name
Back
Next
Employment Eligibility
Are you at least 18 years of age or, if not, can you provide required proof of your eligibility to work?
*
Yes
No
Are you a US citizen or, if not, do you have permission to work in this country?
*
Yes
No
Have you ever been convicted of a misdemeanor, gross misdemeanor, or felony for which a jail sentence could have been or was imposed (do not include juvenile convictions or petty misdemeanors)? This information will not be used to bar you from employment but may be used to direct your interest to areas less related to the area of your conviction.
*
Yes
No
If you answered yes, give complete details here:
Back
Next
References
Use only work or education related references. Do not list relatives.
Reference 1
*
Full Name
Address
City and State
Phone
Occupation
Reference 2
*
Full Name
Address
City and State
Phone
Occupation
Reference 3
*
Full Name
Address
City and State
Phone
Occupation
Back
Next
Additional Information
Select the appropriate level of medical training that you have:
*
No medical training or expired
Basic First Aid
CPR/AED
EMR
EMT
Higher than EMT
Back
Next
Application for Veteran's Preference Points
Eligibility:
Preference points are awarded to qualified veterans and spouses of deceased or disabled veterans to add to their training and experience examination results. Points are awarded subject to the provisions of Minnesota State Statute 43A.11. To be eligible for veteran's preference points, you must be separated under honorable conditions from any branch of the armed forces of the United States after having served on active duty for 181 consecutive days or by reason of disability incurred while serving on active duty, and be a citizen of the United States or resident alien; or be the surviving spouse of a deceased veteran (as defined above) or the spouse of a disabled veteran who because of the disability is not able to qualify. The information you provide on this form will be used to determine your eligibility for veteran's preference points. You are not required to supply this information, but we cannot award veterans points without it.
Instructions:
You must supply a copy of your DD214. Disabled veterans must also supply Form FL-802 or an equivalent letter from a service retirement board. Spouses applying for preference points must supply their marriage certificate, the veteran's DD214 and FL-802 or death certificate. If you do not include these documents with this application, be sure to include your name and the name of the position for which you are applying when you do submit the documents. All documentation must be received no later than 7 calendar days after the application deadline for the position for which you are applying.
Do you intend to apply for Veteran's Preference Points?
*
Yes
No
Continue if you selected yes. Otherwise, please skip to the next page.
Veteran:
Self
Spouse
If spouse, please provide their name.
First Name
Middle Name
Last Name
Branch of Service
Dates of Active Duty (mm/yyyy - mm/yyyy)
Rank at Discharge
Date of Final Discharge
-
Month
-
Day
Year
Date
Type of Discharge
Service Number
Do you have a compensable service-related disability?
Yes
No
Type of Preference Points Requested
Veteran
Disabled Veteran
Spouse of Veteran
Spouse of Disabled Veteran
Supporting Documentation
DD214
Browse Files
Drag and drop files here
Choose a file
Cancel
of
FL-802
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Death Certificate
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
Additional Documents
Please consider uploading a cover letter, resume, and/or supporting documents (not required unless specified by job posting).
Cover Letter
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Resume
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Other Supporting Documents
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
DISCLAIMERS AND WAIVERS
Review carefully:
Waiver and Release
I voluntarily agree to a background check and understand that any violation of internship guidelines may result in termination. I understand I may be exposed to sensitive situations and agree to remain in the patrol unit during incidents unless directed otherwise. I release the City of La Crescent, its employees, and representatives from any liability for injury or damages incurred during this internship.
Authorization to Release Information
Pursuant to Minnesota Statute 13.05, Subd. 4, I authorize the City of La Crescent and its agents to obtain information about me, including data classified as private, for the purpose of evaluating my suitability for internship. A photocopy of this authorization shall be treated as the original.
Final Submit
Please review your application carefully before submitting! By signing below and clicking submit, you are acknowledging that the answers you provided in this application are true and complete to the best of your knowledge. You are also agreeing to the above "Waiver and Release" and "Authorization to Release Information" disclaimers.
Please verify that you are human
*
Signature
Continue
Continue
Should be Empty: