Applicant Information
Name:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email :
Have you ever worked for the City of Escalon?: Yes No
Do you have a valid California Driver Licnese?: Yes No
Driver License Number: Class: Expiration Date:
Have you ever been convicted of a felony: Yes No
If yes, give circumstances:
Are you eligible to be lawfuly employed in the United States: Yes No
Why would you like to become a Police Explorer
Education
Highest Level of Education Completed: 8 9 10 11 12 13 14 15 16 17 18+
Name of High School:
City: State:
Colleges, Trade, or Technical Schools
School Name:
Major: Semester Units Completed:
Degree or Certificate:
Employment Experience
Employer:
Phone Number: Supervisor:
Job Title: Dates Employed: From to
Reason For Leaving:
Work Performed:
List Professional, Trade, Business, or Civic Activities and Offices Held:
Other Qualifications: (Summarize special job-related skills and qualifications acquired from employment or other experience)
State any other additional information you feel may be helpful to us in considering your application
I Hereby certify that the information contained in this application is true and correct to the best of my knowledge. I understand and agree that any intentional misstatement or omission of material fact may be cause for disqualification or termination of employment.
Yes