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Application

Position you are applying for: *

Patrol Deputy
Jail Deputy
Dispatcher
OTHER

Date of application *

How did you learn about us?

Facebook
Newspaper
Other Advertisement
Inquiry
Academy
Other
Relative
Friend

Name *

First

Last

Address *

Street, Apt, City, State, Zip

Date of Birth *

Phone Number *

Email *

Best time for us to contact you? *

Have you applied or worked with us before? *

Yes
No

If yes, please enter date below

Date

Are you a United States Citizen? *

YES
NO

Do you have Relatives that work here? *

Yes
No

Are you currently on "lay-off" status and subject to recall? *

Yes
No

Have you Served in the US Military? *

Yes
No

Employment Desired *

Full-Time
Part-Time
Seasonal/Temporary

Available Start Date *

Are you currently employed? *

Yes
No

Current Employer

May we Contact your employer? *

Yes
No
Not currently employed

Will you be living in Bent County if hired? *

Yes
No

If no, are you willing to move to Bent County? *

Yes
No
Not Applicable (I currently live in Bent County)

All Bent County Sheriff's Office members are required to have a High School Diploma or GED equivalency. *

I have my Diploma or GED
I do not have a Diploma or GED

Did you attend College or University?

Yes
No

Note to Applicant: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.Can you perform the essential functions of the job, for which you are applying, either with or without a reasonable accommodation?

Yes
No

Reference *

Name, Phone Number, Email, Relationship

Reference *

Name, Phone Number, Email, Relationship

In your own words, please explain why you want to work in this field, specifically why do you wish to work for the Bent County Sheriff's Office. * *

I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed one year. Any applicant wishing to be considered for employment beyond this time period should sub¬mit another application. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any em¬ployment relationship with this organization is of an "at will" nature, which means that the Em¬ployee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by a written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that any material false or misleading information given in my application or interviews will result in discharge or re¬moval from the hiring process. I understand also, that I am required to abide by all rules and regulations of the employer. I understand that a background investigation will be conducted, which includes the completion of a personal history statement should my application be considered. Any false or misleading infor¬mation given in the personal history statement will result in discharge. *

Certify

Name

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