Columbus Day News

APPLICATION FOR EMPLOYMENT St. Lucie County Sheriff’s Office An Equal Opportunity Employer Date: APPLICANT INFORMATION Full Name: Last First Middle Street Address: City State Zip Mailing Address (if different from above): City State Zip Phone #: Cell #: Email: SSN: (Required for payroll purposes and is kept confidential) Are ye 18 years or older? ☐ Yes ☐ No Have you ever filed an application with this agency before? ☐ Yes ☐ No If Yes, what date? Are you currently employed? ☐ Yes ☐ No May we contact your current employer? ☐ Yes ☐ No Are you prevented from lawfully becoming employed in this agency because of visa or immigration status? ☐ Yes ☐ No Proof of citizenship or immigration status will be required upon employment. On what date would you be available for work? Desired Salary: POSITION DESIRED Position you are applying for: Type of employment: ☐Full-time ☐Part-time ☐Temporary ☐Contract EDUCATION School Name Address Did you Graduate? Course of Study ☐ Yes ☐ No High School College Other REFERENCES Please list three professional references. Full Name Relationship Phone Address EMPLOYMENT List your last seven (7) years of employment experience, including military service assignments, starting with your most recent employer. Employer Address Phone Dates Employed Starting Salary Ending Salary Job Title Responsibilities Reason for Leaving May we contact your previous supervisor for a reference? ☐ Yes ☐ No Employer Address Phone Dates Employed Starting Salary Ending Salary Job Title Responsibilities Reason for Leaving May we contact your previous supervisor for a reference? ☐ Yes ☐ No Employer Address Phone Dates Employed Starting Salary Ending Salary Job Title Responsibilities Reason for Leaving May we contact your previous supervisor for a reference? ☐ Yes ☐ No MILITARY EXPERIENCE Branch From To Rank at Separation Type of Discharge List duties: DISCLAIMER AND SIGNATURE I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Signature: Date: Sheriff Ken J. Mascara ST. LUCIE COUNTY SHERIFF’S OFFICE 8130 W. Indiantown Road Jupiter, FL 33478