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☐ C N A H E‐ Y ☐ In-State Lateral Application Contact I Name: Address: Date of Birth: ome Phone ‐mail Addres Washington State Police Officer Certification ES ☐ KEN “Co 211 W Informa : ss: NNEWICK mmitted T W. 6th Avenue ♦ Ke tion K POLICE To Your Saf ennewick, WA 99 DEPARTM fety” 9336 ♦ (509) 585 Cell Ph MENT ‐4208 ♦ Fax (509 hone: 9) 582‐9528 ♦ [EMAIL REDACTED] CHIE K.M. wick.wa.us EF OF POLICE . Hohenberg This is the first step in the in-state lateral application process. Please fully complete this application and email it to Human Resource Analyst Janelle Domarotsky at: [EMAIL REDACTED]. You must include a scanned copy of your Peace Officer Certification. After receiving this application, we will email you a personal history statement which must be completed as instructed. If you have any questions, please contact Janelle. By checking YES, you hereby declare you are currently certified as a Washington State Police Officer (If no longer employed you must be within the 24 month window from date of separation). Date of Certification: WA Diver's License Employment Please list your current or most recent employer. Agency: Phone Number: Address: Hire Date: Signature: Date: By typing your name in the signature box you declare the information provided in this document is true and correct to the best of your knowledge. Page 1 of 1 Agency employed by when certified: Rev. 03-16-2016 Separation Date: ---PAGE BREAK--- KENNEWICK POLICE DEPARTMENT KENNEWICK POLICE DEPARTMENT “Committed To Your Safety” 211 W. 6th Avenue ♦ Kennewick, WA 99336 ♦ (509) 585-4208 ♦ Fax (509) 582-9528 ♦ [EMAIL REDACTED] MEDIA RESOURCE QUESTIONNAIRE (This page must be completed and submitted with your application) (please print) Applicant Name Date: How did you first hear about the open positions at KPD? Please check the box that applies AND provide info regarding corresponding venue or media source. For example, if you found out about our open positions on Facebook check “Social Media” and list the specific Facebook page you discovered us on. Newspaper Publication Name Internet Website Name Career Fair Month/Year and Location Social Media Page Name College/University/Military Presentation Institute Name and Location Other Please Explain CHIEF OF POLICE K.M. Hohenberg