Atmore Police Department Employment Application

1
Notice To the Applicant

We deeply appreciate your interest in the Atmore Police Department. The Civil Rights Act of 1964 prohibits discrimination in employment based on race, color, religion, sex, or national origin. Federal law also prohibits other types of discrimination, including age, citizenship, disability, veteran status, receipt of benefits, and participation in union activities. This list is not exhaustive of all grounds on which discrimination is prohibited.

Before completing this Applications, you'll need the following information before completing this Application:

1. Driver's License Number

2. Two References

3. Previous Employment Information (Dates, Wages)

4. Criminal History Information
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Date of Application:* This field is required.
Date
Month
Day
Year
3
1. Position Applied For:* This field is required.
Dispatcher
Police Officer
Other:
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If other, Type position.Only type if position ii not listed.
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2. Full Legal Name:* This field is required.
First Name
Middle Initial
Last Name
6
3. Mailing Address:* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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4. Phone:* This field is required.
8
5. Email Address:* This field is required.
example@example.com
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6. Are you eligible to work in the U.S.?* This field is required.
Yes
No
10
7. Driver's License #:* This field is required.
11
State:* This field is required.
12
8. Military Experience?* This field is required.Have you been discharged from Military Service or still serve under reserve status.
Yes
No
13
Are you a Certified Law Enforcement Officer? If so please if known write your Certificate Number.
14
Years of Post Highschool Education (College, Military, Other)* This field is required.
0
1
2
3
4
5
6
6+
15
Do you have a High School Diploma or GED?* This field is required.
Yes
No
16
Year Received High School Diploma or GED:* This field is required.
17
Location of School or Training:* This field is required.
18
Do you expect to have a Degree in the future due to being currently enrolled in school?
19
Institution attended (1):
20
Degree Obtained (1):
21
Major (1):
22
Dates Attended (1):
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Institution Attended (2):
24
Degree Obtained (2):
25
Major (2):
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Dates Attended (2):
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List a Skill* This field is required.
28
List a SkillIf Applicable
29
List a SkillIf Applicable
30
List a SkillIf Applicable
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NOTICE TO APPLICANT

The Atmore Police Department will conduct an extensive background check on your past employment if you are applying for the position of Police Officer. Even though you may select an employer not to be contacted, notice by law, the employer may still be contacted regarding completing checks.

Alabama Law 36-21-55.1 Creation of Database; Reporting of Information; Maintenance and Confidentiality

(a)(1) By October 1, 2023, the Alabama Peace Officers’ Standards and Training Commission shall develop, implement, and maintain a centralized and electronic Law Enforcement Officer Employment Database. The database shall include, but shall not be limited to, all of the following reportable offenses:

a. Dates of hire, appointment, and reportable separation as defined in Section 36-21-55 of a law enforcement officer from any law enforcement agency through which the officer is or has been employed.

b. Information relating to disciplinary action as defined in Section 36-21-55 taken by a law enforcement agency against a law enforcement officer.

c. Use of force complaints as defined in Section 36-21-55 against a law enforcement officer.

d. Any instance of a law enforcement officer’s reassignment for cause as defined in Section 36-21-55.

e. Status of compliance with continuing education requirements.

....

Alabama Law 36-21-55.2 Disclosure of Information.

(a) Any law enforcement agency that is a potential employer of a law enforcement officer shall request, through the database from the commission, either in writing or electronically, disclosure of the information maintained by the commission as required in subdivisions (b)(1) and (b)(2) of Section 36-21-55.1.

(b) In the event that the database does not include information with respect to the law enforcement officer, any law enforcement agency that previously employed or appointed the law enforcement officer, upon receiving a written request from an employing law enforcement agency in this state, shall disclose a full and fair description of the former law enforcement officer’s employment history with that agency to include the information in subdivisions (b)(1) and (b)(2) of Section 36-21-55.1, if available.

(c) Information disclosed pursuant to subsection (b) shall only be used for employment or appointment decisions, and the law enforcement agency receiving the disclosures shall maintain the confidentiality of the employment or appointment information.

(d) An individual acting on behalf of a law enforcement agency shall be immune from civil liability for disclosing information required by this section if that disclosure was made in good faith and in response to a proper written request made pursuant to this division.

(Act 2021-268, §3.)
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(INCLUDE YOUR LAST THREE EMPLOYERS IF APPLICABLE)
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Job Title (1)
34
Starting Salary (1)
35
Last Salary (1)
36
Employer Name
37
Supervisor :
38
Phone :
39
Dates EmployedType Date
40
to Date of SeperationType Date
41
Duties:Type duties that were responsible for.
42
Hours Per Week:
43
Reason for Leaving
44
May we contact this employer?
Yes
No
45
If No, why?If you selected no type why below.
46
Job Title
47
Starting Salary
48
Last Salary
49
Employer Name
50
Supervisor
51
Phone
52
Date Employed From
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Date Employed To
54
Duties
55
Hours Per Week
56
Reason for Leaving
57
May we contact this employer?
Yes
No
58
If No, why?
59
Job Title:
60
Starting Salary
61
Last Salary
62
Employer Name:
63
Supervisor:
64
Phone:
65
Dates Employed: From
66
to
67
Duties
68
Hours Per Week
69
Reason for Leaving:
70
May we contact this employer?
Yes
No
71
If No, why?
72
(Provide at least 2 non-family references)
73
Name * This field is required.
74
Occupation* This field is required.
75
Phone * This field is required.
76
Name * This field is required.
77
Occupation* This field is required.
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Phone* This field is required.
79
Upload Resume
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
80
Type of License you currently have (Commercial, Normal) :
81
License #:
82
Class:* This field is required.What class License? E,D,V,C,A example
83
Number:* This field is required.
84
State Issued:* This field is required.
85
Has your License ever been Revoked/Suspended?* This field is required.
Yes
No
86
If Yes, explain:Explain why your license was suspended or revoked if applicable.
87
Have you ever been found the primary contributor to a Motor Vehicle Crash?* This field is required.Where you found at fault in regards to a motor vehicle crash in the past.
Yes
No
88
Do you have issues with finding vehicle insurance companies insuring you to operate a vehicle?* This field is required.Will a insurance company refuse to cover you?
Yes
No.
89
Have you applied to the City of Atmore before?* This field is required.
Yes
No
90
Are You related to anyone employed here?* This field is required.City of Atmore
Yes
No
91
c. Have you ever been terminated or asked to resign from a job?* This field is required.
Yes
No
92
If Yes, explain:
93
d. Have you ever been Suspended or received reprimand at any job in the past?* This field is required.
Yes
No
94
If Yes, explain:
95
e. Have you ever been convicted of felony or misdemeanor?* This field is required.
Yes
No
96
If Yes, explain:
97
f. Have you ever Stolen/shoplifted anything over the age of 18?* This field is required.
Yes
No
98
If Yes, explain:
99
g. Have you ever received property believed to be stolen?* This field is required.
Yes
No
100
If Yes, explain:
101
h. Have you ever been arrested for any criminal offense, regardless of conviction or dissolve?* This field is required.
Yes
No
102
If Yes, explain:
103
i. Have you ever been committed for a mental health reason?* This field is required.
Yes
No
104
If Yes, explain:
105
j. Have you ever been under internal investigation for excessive use of force and or bias actions, and found to be in violation of such either by Departmental Policy and or Law?* This field is required.
Yes
No
106
If Yes, explain:
107
I certify that the information provided in this application is true and complete.
I authorize the City of Atmore to investigate all information submitted in connection with my application for employment, including matters concerning my past employment, character, education records, and ability to perform the essential functions of the position for which I am applying.

I release all individuals, companies, and organizations providing such information, as well as the City of Atmore, from any liability arising from the release or use of this information.

I understand that this application becomes the property of the City of Atmore and will not be returned to me.

I acknowledge that an extensive background check will be conducted, and I will not have access to any information obtained during this process. I waive any right to receive explanations regarding how information was used in the selection process or reasons for non-employment.

I understand that the City of Atmore is a drug-free workplace. As an applicant receiving a conditional offer of employment, I may be required to undergo drug and alcohol screening. As an employee, I may be subject to random drug and alcohol testing. I may review the City's current drug and alcohol testing policy, which may be updated periodically.

I understand that I must be able to perform the essential functions of the position for which I am applying, with or without reasonable accommodations.

I acknowledge that the City of Atmore may reject my application or terminate my employment if I provide false or misleading information, or attempt to commit any fraud or deception during the application or selection process.

I understand that my application may be considered a public record and may be subject to disclosure.

If this form is completed electronically, printing my name on the signature line constitutes my official signature.
108
I certify that under the penalty of perjury, all the information provided in all pages of this document is true and correct, and furthermore I consent to all the information provided in the waiver(s) of this document.
109
Applicant Signature* This field is required.Sign if you fully understand all information stated.
110
DATE* This field is required.
Date
Month
Day
Year
Should be Empty: