CharlotteCollierGladesHendryLee
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Training CompletedYesNo
Are you a current or former law enforcement officer, other covered employee, or the spouse or child of one?YesNo
Have you ever been convicted of a felony or a first degree misdemeanor?
Select OneYesNo
Have you ever pled nolo contendere or pled guilty to a crime which is a felony or a first degree misdemeanor?
Have you ever had the adjudication of guilt withheld for a crime which is a felony or a first degree misdemeanor?
Are you a U.S. citizen?YesNo
If no, are you legally authorized to accept employment with the specific hiring authority to which you are applying?YesNo
To your knowledge, do you have any relatives working in this agency?YesNo
If you are a male born after October 1, 1962, have you registered with the Selective Service or do you have proof of an exemption from this requirement?YesNoNot Applicable
Are you currently employed with the agency to which you are currently applying?YesNo
Have you received a promotional appointment within the career service, subsequent to active military service, with the agency to which you are applying?YesNo
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I am aware that any omissions, falsifications, misstatements, or misrepresentations above may disqualify me for employment consideration and, if I am hired, may be grounds for termination at a later date. I understand that any information I give may be investigated as allowed by law. I consent to the release of information about my ability, employment history, and fitness for employment by employers, schools, law enforcement agencies, and other individuals and organizations to investigators, human resources staff, and other authorized employees of Florida state government for employment purposes. I understand that applications submitted for state employment are public records. I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith.
