Application for employment law enforcement, jail or secure juvenile detention officer




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Wisconsin Department of Justice

Law Enforcement Standards Board

DJ-LE-330, Rev. 2/11

www.wilenet.org
APPLICATION FOR EMPLOYMENT

LAW ENFORCEMENT, JAIL OR SECURE JUVENILE DETENTION OFFICER
NOTICE: All questions must be answered. Incomplete or illegible applications will not be considered. If the space provided is insufficient for complete answers or you wish to furnish additional information, please attach additional pages.


1. PERSONAL INFORMATION

Name (Last, First, Middle)

     


Social Security # (xxx-xx-xxxx)

     


Address (Apartment, Street, P.O. Box)

     


Home Telephone Number

     


City

     


State

     


Zip Code

     


Work Telephone Number

     

Email Address

     


Cell Phone Number

     


Have you successfully completed the basic training required for certification (i.e. 520-hour law enforcement academy)? Yes  No 

If yes, what type(s) of basic training have you successfully completed? Law Enforcement  Jail  Secure Juvenile Detention 


If applicable, include the name of the school where you completed basic training and the date that training was completed:
     



Are you at least 18 years old? Yes  No 

Are you a United States citizen? Yes  No 

Do you have a high school diploma, GED or HSED? Yes  No 

Do you have an Associate Degree or 60 associate degree level credits or higher from an accredited college or university? Yes  No 

If No, were you employed as a law enforcement officer prior to February 1, 1993? Yes  No 

The college credit requirement as written in Wisconsin Administrative Code § LES 2.01(1)(e), pertains to law enforcement and tribal law enforcement officers first employed on or after February 1, 1993.



Have you ever been convicted of a felony? Yes  No 

Have you ever been convicted of a misdemeanor crime of domestic violence? Yes  No 

Are you prohibited by state or federal law from possessing a firearm? Yes  No 

Do you possess a valid Wisconsin driver’s license or a valid driver’s license from another state? Yes  No 

2. EDUCATION




Dates




Name of School(s)

From (mm/yyyy)

To (mm/yyyy)

Degree, Diploma, or Credits Earned

High School(s)

     

     

     

     

     

     

     

     

College(s)

     

     

     

     

     

     

     

     

3. EMPLOYMENT


Begin with current or most recent employer. List chronologically all employment, including summer and part-time employment while attending school. To furnish additional employment information, attach sheets of the same size and format as this application.


Name and Address of Employer

Dates of Employment

From (mm/yyyy)

To (mm/yyyy)

Name of Employer:

     


     

     

Address:

     


Full-Time  Part-Time 

Annual Salary/Wages:

     


City:

     


State:

     


Zip Code:

     


Supervisor’s Name / Telephone Number:

     


May we contact the employer / supervisor?

Yes  No 

Position and kind of work:

     


Reason for Leaving:

     





Name and Address of Employer

Dates of Employment

From (mm/yyyy)

To (mm/yyyy)

Name of Employer:

     


     

     

Address:

     


Full-Time  Part-Time 

Annual Salary/Wages:

     


City:

     


State:

     


Zip Code:

     


Supervisor’s Name / Telephone Number:

     


May we contact the employer / supervisor?

Yes  No 

Position and kind of work:

     


Reason for Leaving:

     





Name and Address of Employer

Dates of Employment

From (mm/yyyy)

To (mm/yyyy)

Name of Employer:

     


     

     

Address:

     


Full-Time  Part-Time 

Annual Salary/Wages:

     


City

     


State:

     


Zip Code:

     


Supervisor’s Name / Telephone Number:

     


May we contact the employer / supervisor?

Yes  No 

Position and kind of work:

     


Reason for Leaving:

     





4. MILITARY SERVICE


Branch of Service

From (mm/yyyy)

To (mm/yyyy)

Active Duty or Reserve

Highest Grade


Skill Specialty or Primary Duty

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

Honorably Discharged from Military Service? Yes  No  Not Applicable 

5. REFERENCES


Give three references (not relatives, or present employer; avoid listing members of the clergy).

Name:      

Position/Title/Profession:      

Number of Years Acquainted:      

Address:      

City/State/Zip:      

Telephone Number:      




Name:      

Position/Title/Profession:      

Number of Years Acquainted:      

Address:      

City/State/Zip:      

Telephone Number:      




Name:      

Position/Title/Profession:      

Number of Years Acquainted:      

Address:      

City/State/Zip:      

Telephone Number:      




6. GENERAL


COMPLETE IF INSTRUCTED TO DO SO BY EMPLOYING AGENCY.

Attach no more than one additional page for each answer.

  1. Why have you chosen to apply for this position?

  2. Discuss things you have done which have contributed to your life experience. Be sure to include information regarding volunteer work with civic, school, or professional organizations. Be specific about names and dates.

  3. Why do you believe you could relate to and/or work with people of different races, genders, cultures, ages, socio-economic groups, and educational levels?


APPLICANT PLEASE READ CAREFULLY AND SIGN BELOW

Information provided and statements made as part of this application may be grounds for not employing you or for dismissing you after you begin work. All information and statements made are subject to verification.




CERTIFICATION
ALL INFORMATION PROVIDED AND STATEMENTS MADE BY ME AS PART OF THIS APPLICATION, OR AS PART OF ANY ADDITIONAL INFORMATION PROVIDED IN SUPPORT OF THIS APPLICATION, ARE COMPLETE, CORRECT, AND TRUE TO THE BEST OF MY KNOWLEDGE.
I UNDERSTAND THAT IF I AM EMPLOYED, FALSE INFORMATION PROVIDED OR FALSE STATEMENTS MADE AS PART OF THIS APPLICATION MAY BE CONSIDERED AS CAUSE FOR DISMISSAL.


     


Applicants Signature

     


Date Signed

Under the provisions of § 19.36, Wis. Stats., I request that my identity as an applicant for this position not be revealed without my consent or until required under law.




     


Applicants Signature

     


Date Signed






Type to add additional pages.





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