ECSO CIVILIAN EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION

Instructions: Please complete all questions on this application. If a question is not applicable to you, place N/A. All information must be correct to the best of your knowledge at the time of the application. Answer all questions on the application even if your resume has been attached.
GENERAL INFORMATION
Position Applied for:*
Full Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
You must be 18 to apply
Social Security Number*
Gender*
Race
DL Number/State*
Residential Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Are you a United States Citizen or authorized to work in the United States?*

CRIMINAL BACKGROUND INFORMATION
Have you ever been convicted of a Crime?*
NOTE: A conviction does not automatically mean you cannot be hired. What you were convicted of, and how long ago, are essential. Give all facts so that a decision can be made.
If yes, explain in detail:

EDUCATION
Highest Level of Education*
Did you graduate?*
Name of Educational Institution*
Degree or Certification Obtained
Graduation Year
List languages, other than English, you speak and/or write fluently which you are willing to use during employment (including braille and sign language)

WORK EXPERIENCE
You are required to attach your resume and work experience to this application. Your resume should include the names and numbers of your previous and current employers.
File Upload*

Cancelof
List your current and prior employment below.
Company Name*
From

MonthDayYear
Date
To

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Position
Name of supervisor
Description of duties and responsibilities
Reason for leaving
Company Name
From

MonthDayYear
Date
To

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Position
Name of supervisor
Description of duties and responsibilities
Reason for leaving
Do you have prior Law Enforcement experience?*
If yes, explain in detail:
Do you possess any special licenses, certifications, permits, or skills?*
If yes, explain in detail:
Have you ever been employed by the County of Essex*
Department
Dates of employment
Are you now or have you ever been a member of a local, state or federal retirement system?*
Name of retirement system

EMPLOYMENT APPLICATION