PRELIMINARY APPLICATION FOR EMPLOYMENT
THIS APPLICATION BECOMES VOID AFTER (60) DAYS UNLESS RENEWED
STATEMENT OF POLICY: EMPLOYMENT WITH THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE IS BASED ON INDIVIDUAL MERIT. EMPLOYMENT OPPORTUNITIES ARE
PROVIDED WITHOUT REGARD TO RACE, COLOR, SEX, AGE, MARITAL STATUS, RELIGION, NATIONAL ORIGIN, CITIZENSHIP, DISABILITY OR VETERAN STATUS.
NO
QUESTION ON THIS APPLICATION IS ASKED FOR THE PURPOSE OF LIMITING OR EXCLUDING ANY APPLICANT’S CONSIDERATION FOR EMPLOYMENT BECAUSE OF THE
APPLICANT’S INCLUSION IN ANY SUCH CATEGORIES.
INSTRUCTIONS TO ALL APPLICANTS: THE CAREFUL AND THOUGHTFUL COMPLETION OF THIS APPLICATION IS AN IMPORTANT STEP IN OUR CONSIDERATION OF
INDIVIDUALS FOR EMPLOYMENT. THEREFORE, YOU MUST COMPLETE THE ENTIRE APPLICATION. IF YOU DO NOT, YOU WILL NOT BE CONSIDERED FOR EMPLOYMENT.
YOUR APPLICATION MUST ALSO SPECIFY THE POSITION YOU ARE APPLYING FOR; STATING THAT YOU WILL DO “ANYTHING” IS TOO INDEFINITE AND WILL RESULT IN YOUR
APPLICATION NOT BEING ACCEPTED BY THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE. RESUMES ARE NOT ACCEPTED INSTEAD OF FULL COMPLETION OF THIS
APPLICATION.
PLEASE BE FURTHER ADVISED THAT YOUR APPLICATION WILL BE ACTIVE FOR THE CURRENT POSITION APPLIED FOR ONLY. ONCE THAT RECRUITMENT HAS ENDED, YOU
WILL NEED TO REAPPLY FOR ANY ADDITIONAL POSITIONS YOU ARE INTERESTED IN APPLYING FOR.
PLEASE PRINT IN INK AND USE YOUR OWN HANDWRITING. DO NOT REMOVE THIS APPLICATION FROM THE PERSONNEL OFFICE UNLESS INSTRUCTED TO DO SO. USE THE
SPACE ON THE LAST PAGE TO CLARIFY ANY RESPONSES OR, IF DESIRED, TELL US ANYTHING ELSE ABOUT YOURSELF YOU BELIEVE RELEVANT.
Today’s Date: _____________________________
NAME- LAST
FIRST
HOME ADDRESS-STREET
MIDDLE
HAVE YOU FILED AN APPLICATION HERE BEFORE?
YES
NO
IF “YES,” GIVE DATE
STATE ZIP CODE
CITY
ARE YOU AT LEAST 18 YEARS OF AGE?
YES
NO
SOCIAL SECURITY NUMBER: _____________-_________-_____________
POSITION APPLYING FOR (USE SPECIFIC TITLE, IF KNOWN)
SALARY EXPECTED
HAVE YOU EVER BEEN EMPLOYED BY THE CENTRAL FLORIDA POLICE ATHLETIC
LEAGUE?
YES
NO
IF “YES,” WHEN, WHERE, AND IN WHAT POSITION?
TELEPHONE NO.
ARE YOU RELATED TO ANYONE CURRENTLY EMPLOYED BY
CENTRAL FLORIDA POLICE ATHLETIC LEAGUE?
YES
NO
ARE YOU WILLING TO WORK:
NIGHTS:
YES
NO
WEEKENDS:
YES
NO
ARE YOU ABLE TO PERFORM THE DUTIES OF THE POSITION SOUGHT (AS DESCRIBED ON THE
ATTACHED JOB DESCRIPTION) WITH OR WITHOUT REASONABLE ACCOMMODATION?
NO
YES
HOW WERE YOU REFERRED? (CIRCLE ONE)
ADVERTISEMENT FRIEND RELATIVE WALK-IN
STATE EMPLOYMENT SERVICE EMPLOYEE OTHER
HAVE YOU EVER BEEN CONVICTED OF A CRIME, PLED NO CONTEST, OR BEEN A DEFENDANT IN A CIVIL ACTION FOR AN INTENTIONAL TORT?
YES
NO
IF YES, PLEASE LIST THE OFFENSE, DATES AND DISPOSITION OF THE CASE (CONVICTIONS WILL NOT NECESSARILY DISQUALIFY YOU FOR THE POSITION).
IF HIRED, CAN YOU PROVIDE VERIFICATION OF YOUR LEGAL RIGHT TO WORK IN THE UNITED STATES?
YES
NO
TYPE OF SCHOOL
SCHOOL NAME
SCHOOL LOCATION
GRADUATE? TYPE OF
YES OR NO DEGREE
GRADE POINT OR MAJOR SUBJECT
CLASS RANK
HIGH SCHOOL/GED
TECHNICAL
VOCATIONAL
COLLEGE OR UNIVERSITY
GRADUATE SCHOOL
OTHER, INCLUDE MILITARY
SCHOOLS
*IF YOU HAVE A LICENSE OR CERTIFICATION(S), GIVE YOUR LICENSE OR CERTIFICATION NUMBER(S) HERE.
PLEASE INDICATE SKILLS LISTED BELOW YOU ARE PROFICIENT IN:
COMPUTER SOFTWARE SKILLS:__________________________________________________________________________________________________________
LIST ALL EMPLOYERS IN ORDER WITH THE LAST OR PRESENT EMPLOYER(S) FIRST INCLUDING PART-TIME EMPLOYERS
SEE RESUME IS NOT ACCEPTABLE
DATES
NAME, ADDRESS AND PHONE NUMBER OF
EMPLOYER
RATE OF PAY
SUPERVISOR’S NAME AND TITLE
FROM
TO
START
FINISH
JOB TITLE:_____________________________________________
DESCRIBE IN DETAIL THE WORK YOU DID:
ARE YOU ELIGIBLE FOR REHIRE BY THIS COMPANY?
DATES
FROM
TO
YES
NAME, ADDRESS AND PHONE NUMBER OF
EMPLOYER
NO
REASON FOR LEAVING
IF “NO,” WHY?
RATE OF PAY
START
FINISH
SUPERVISOR’S NAME AND TITLE
REASON FOR LEAVING
JOB TITLE:_____________________________________________
ARE YOU ELIGIBLE FOR REHIRE BY THIS COMPANY?
DATES
YES
NAME, ADDRESS AND PHONE NUMBER OF
EMPLOYER
DESCRIBE IN DETAIL THE WORK YOU DID:
NO
IF “NO,” WHY?
SUPERVISOR’S NAME AND TITLE
RATE OF PAY
FROM
TO
START
FINISH
JOB TITLE:_____________________________________________
DESCRIBE IN DETAIL THE WORK YOU DID:
ARE YOU ELIGIBLE FOR REHIRE BY THIS COMPANY?
DATES
YES
NAME, ADDRESS AND PHONE NUMBER OF
EMPLOYER
NO
IF “NO,” WHY?
SUPERVISOR’S NAME AND TITLE
RATE OF PAY
FROM
TO
START
FINISH
JOB TITLE:_____________________________________________
DESCRIBE IN DETAIL THE WORK YOU DID:
ARE YOU ELIGIBLE FOR REHIRE BY THIS COMPANY?
YES
NO
REASON FOR LEAVING
REASON FOR LEAVING
IF “NO,” WHY?
PLEASE EXPLAIN ALL GAPS IN YOUR EMPLOYMENT WHICH HAVE EXCEEDED ONE (1) MONTH FROM THE DATE YOU BEGAN YOUR MOST RECENT JOB TO
THE PRESEN
SHOULD WE EXPECT TO RECEIVE ANY “NEGATIVE” COMMENTS FROM ANY OF YOUR PREVIOUS EMPLOYERS?
YES
NO IF “YES,” EXPLAIN WHY:
_________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________
HAVE YOU EVER BEEN DISCHARGED OR SUSPENDED FROM EMPLOYMENT?
YES
NO IF “YES,” DESCRIBE THE REASONS FOR
DISCHARGE/SUSPENSION IN DETAIL:
HAVE YOU EVER BEEN BONDED?
YES
NO IF “YES,” WHEN? __________________________________________________________________
FOR WHOM?
DRIVER’S LICENSE NO. AND STATE ISSUED
ANY RESTRICTION ON TRAVEL?
YES
NO
I CERTIFY THAT ALL OF THE INFORMATION FURNISHED ON THIS APPLICATION IS TRUE, COMPLETE AND CORRECT. I UNDERSTAND AND AGREE THAT ANY
FALSIFICATION, MISREPRESENTATION, MISLEADING STATEMENT, OR OMISSION OF FACT ON EITHER THIS APPLICATION OR DURING THE PRE-HIRE
PROCESS WILL BE SUFFICIENT REASON FOR (1) MY NOT BEING OFFERED EMPLOYMENT; OR (2) DISMISSAL AT ANY TIME IF I AM EMPLOYED.
I AUTHORIZE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE TO CONTACT MY PREVIOUS EMPLOYERS FOR THE PURPOSE OF CHECKING MY
EMPLOYMENT HISTORY. MY SIGNATURE BELOW CONSTITUTES MY KNOWING AND VOLUNTARY WAIVER OF ANY CLAIMS I MAY HAVE AGAINST THE
CENTRAL FLORIDA POLICE ATHLETIC LEAGUE FOR CONTACTING MY PREVIOUS EMPLOYERS. I ALSO WAIVE AND RELEASE MY PREVIOUS EMPLOYERS
FROM ANY CLAIMS I MAY HAVE AGAINST THEM BASED UPON THE INFORMATION THEY FURNISH TO THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE.
IN MAKING THIS APPLICATION FOR EMPLOYMENT, IT IS UNDERSTOOD THAT A COPY OF A CONSUMER REPORT PREPARED BY A CONSUMER REPORTING
AGENCY, ALSO KNOWN AS A CREDIT REPORT, MAY BE OBTAINED AS A PART OF A ROUTINE BACKGROUND CHECK. INFORMATION FROM THE REPORT
WILL NOT BE USED IN VIOLATION OF ANY FEDERAL OR STATE EQUAL OPPORTUNITY LAW OR REGULATION. BEFORE TAKING ANY ADVERSE EMPLOYMENT
ACTION BASED ON THE CREDIT REPORT, INCLUDING DENYING EMPLOYMENT, THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE WILL PROVIDE TO YOU,
WITHOUT CHARGE, A COPY OF THE REPORT PLUS A WRITTEN SUMMARY OF CONSUMER RIGHTS UNDER THE FAIR CREDIT REPORTING ACT.
I UNDERSTAND AND AGREE THAT MY EMPLOYMENT IS FOR NO DEFINITE PERIOD OF TIME AND MAY, REGARDLESS OF THE TIME AND MANNER OF
PAYMENT OF MY WAGES, BE TERMINATED AT ANY TIME BY ME OR THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE, WITH OR WITHOUT CAUSE, AND
WITHOUT ANY PREVIOUS NOTICE. I ALSO UNDERSTAND AND AGREE THAT THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE HAS THE RIGHT TO
UNILATERALLY MODIFY AND/OR TERMINATE ANY POLICIES, PRACTICES, PROCEDURES, AND STANDARDS IT HAS ADOPTED OR IMPLEMENTED, TO THE
EXTENT NOT LIMITED BY LAW.
IN THE EVENT OF MY EMPLOYMENT BY THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE, I WILL COMPLY WITH ALL RULES AND REGULATIONS AS SET
FORTH IN ITS POLICY MANUAL OR OTHER COMMUNICATION DISTRIBUTED TO EMPLOYEES.
I UNDERSTAND THAT EMPLOYMENT WITH THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE MAY BE CONDITIONED UPON A NEGATIVE DRUG AND/OR
ALCOHOL SCREENING TEST RESULT ADMINISTERED BY A MEDICAL ORGANIZATION SELECTED BY THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE. I
FURTHER AGREE TO SUBMIT, AT ANY REASONABLE TIME DURING MY EMPLOYMENT, AND WITHOUT NOTICE, TO A DRUG AND/OR ALCOHOL SCREENING
TEST. I UNDERSTAND THAT REFUSAL TO TAKE A REQUESTED DRUG AND/OR ALCOHOL SCREENING MAY RESULT IN DISCHARGE. I FURTHER
UNDERSTAND THAT, IF EMPLOYED, A POSITIVE TEST RESULT MAY ALSO RESULT IN IMMEDIATE DISCHARGE.
I AUTHORIZE THE CENTRAL FLORIDA POLICE ATHLETIC LEAGUE TO SUPPLY MY EMPLOYMENT RECORDS, IN WHOLE OR IN PART, TO ANY PROSPECTIVE
EMPLOYER, GOVERNMENTAL AGENCY, OR OTHER PARTY WITH A LEGAL INTEREST, AND I RELEASE ALL SUCH PARTIES FROM ANY LIABILITY FOR DIRECT
OR CONSEQUENTIAL DAMAGES RESULTING FROM SUCH RELEASE AND DISCLOSURE.
I HAVE READ, UNDERSTAND THE FOREGOING, AND BY MY SIGNATURE BELOW, I ACCEPT THE ABOVE TERMS AND CONDITIONS FOR EMPLOYMENT, IF I
AM OFFERED A POSITION.
SIGNATURE
PRINTED NAME
DATE
DO NOT WRITE BELOW THIS LINE
ANOTHER APPLICANT WAS SELECTED BASED ON OVERALL BETTER/MORE QUALIFICATIONS, EXPERIENCE AND/OR SKILL MIX.
THIS APPLICANT DOES NOT HAVE THE QUALIFICATIONS, TRAINING AND/OR EXPERIENCE REQUIRED FOR THE EMPLOYMENT POSITION BEING
CONSIDERED.
WE CURRENTLY DO NOT HAVE A POSITION OR EMPLOYMENT OPENING IN THE AREAS OF THIS APPLICANT’S QUALIFICATIONS AND EXPERIENCE.
EMPLOYMENT OPENING APPLIED FOR WAS FILLED BEFORE PROCESSING OF THIS APPLICATION.
UNABLE TO CONTACT BY TELEPHONE.
ADDITIONAL COMMENTS.
OFFER OF EMPLOYMENT GIVEN:
BACKGROUND CHECK AUTHORIZATION
In making this application for employment, it is understood that a copy of a background check report prepared by a
consumer reporting agency may be obtained. Information from the report will not be used in violation of any federal or
state equal opportunity law or regulation.
I, __________________________, acknowledge receipt of a separate disclosure that a background check
report may be obtained. I hereby authorize a copy of my background check report from a consumer reporting
agency to be released to The Central Florida Police Athletic League.
_____________________________________
Signature
_________________________
Date