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POLICE OFFICER APPLICATION PACKET Town of Monument Police Department ---PAGE BREAK--- Page 2 of 16 Revised 6/13/22 IMPORTANT INSTRUCTIONS Thank you for your interest in becoming a Police Officer with the Monument Police Department. The Monument Police Department requires exemplary levels of personal integrity, dedication, and professionalism of all staff members in order to provide an interactive, service-oriented partnership with the community we serve. This application is the first step in being considered for the position of Police Officer for the Town of Monument. The application packet must be completed in full. All information on this application is subject to verification. The Monument Police Department is an Equal Opportunity Employer. Please read the important instructions listed below: Print the entire application packet as single sided pages – DO NOT print on both sides of the paper. Type or handprint in ink an answer to every question. Applications must be legible. Provide complete and accurate information for each question. If a question does not apply to you, mark N/A in the space provided. If space is insufficient, attach a separate sheet and precede the additional information with the section title to which you are referring. It is your responsibility to notify this department of any changes of address, phone number, or email address. If you provide false information, or commit any omissions of fact, either intentionally or unintentionally, you will not be eligible to participate in the selection process. Failure to admit convictions, and/or any untruthfulness will result in disqualification. Sign and date page 15. Sign, date, and notarize page 16. Application packets that are not signed and notarized will not be accepted. Faxed packets will not be accepted. Mail, email, or drop off your completed application packet to: Monument Police Department Attention: Commander John Lupton Monument, CO 80132 [EMAIL REDACTED] Application Packets will be accepted until the position is filled. You MUST also complete the application on BambooHR ---PAGE BREAK--- Page 3 of 16 Revised 6/13/22 SELECTION PROCESS Applicants who qualify to move forward in the Selection Process will be contacted by email inviting them to participate in the next scheduled examination process. The Selection Process for Police Officer consists of three phases. Candidates may be eliminated from the selection process at any stage of the process at the discretion of the Police Department. Phase 1 • Submission of the Police Officer Application Packet, revision date 6/13/22, along with copies of the following documents: Current Driver’s License Colorado POST Certificate (or proof of current attendance in a POST Academy) High School Diploma or GED A testing process Oral Board Interview Chief’s Interview Phase 2 Comprehensive Background Investigation Polygraph/CVSA Examination Job Suitability Assessment Phase 3 Medical Examination Drug Screen Successful candidates who are hired as a Police Officer enter an intensive 12-week Field Training Program ---PAGE BREAK--- Page 4 of 16 Revised 6/13/22 DUTIES AND MAJOR RESPONSIBILITIES Performs the duties directly associated with the enforcement of the law. Routine patrol includes building security, investigation of criminal and non-criminal complaints, traffic control and motorist assists. KNOWLEDGE, SKILLS, AND ABILITIES Ability to communicate effectively; knowledge of the laws, regulations, policies and procedures pertaining to the operations of the Department; ability to work harmoniously with the staff and public. MINIMUM QUALIFICATIONS In order to qualify for entry into the initial stages of the Police Officer Selection process, a candidate must meet the following specifications: 1. Minimum age 21 2. Colorado P.O.S.T certified/or Certifiable as required by POST (or proof of current attendance in a POST Academy) 3. High School diploma or equivalent 4. Possess or be able to obtain a Colorado Driver’s License prior to employment 5. Must be in good health. Eyesight must be correctable to 20/20 6. No felony or domestic violence convictions 7. Must be financially responsible SALARY AND BENEFITS Beginning salary for Police Officer is $52,000 per year. Additional pay for lateral officers may be available DOE. The Town of Monument offers a comprehensive benefits package which offers several health, dental, and vision insurance options. All employees are entitled to worker’s compensation administered through the Town of Monument. This coverage provides for protection for an employee absent from work due to job related injury or illness. RETIREMENT PLAN All full-time officers must participate in the FPPA Retirement Plan coordinated through the Town of Monument. The cost of the plan is shared by the employee and the Town. The employee must contribute 5% of the employee’s gross salary, pre-taxed. ---PAGE BREAK--- Page 5 of 16 Revised 6/13/22 Date: Last Name First Name Middle Name Maiden Name Date of Birth Social Security Number In accordance with the Federal Privacy Act of 1974, disclosure is voluntary. The SSN will be used for identification purposes to ensure proper records are obtained. Give any other names you have been known by: Street Address City and State Zip Code Mailing Address (if different than above) City and State Zip Code Home Phone Number Work Phone Number Cell Phone Number Email Address (Please Print) (You must provide an email address. All communication for the testing and hiring processes will be done by email. Please ensure your email address is legible) Are you legally authorized to work in the United States? Yes No Do you have or have you had any injuries or illnesses which may prevent you from performing the duties of the position of Police Officer? Yes No If yes, please explain: ---PAGE BREAK--- Page 6 of 16 Revised 6/13/22 EMPLOYMENT HISTORY Have you ever worked as a police/law enforcement officer? Yes No How many years of full time, paid police/law enforcement experience do you have? Have you ever graduated from a state certified law enforcement training academy, or are you currently enrolled in one? Yes No If “Yes” Academy Name, date, and Post certificate number (or pending graduation date). List your employment history beginning with your present or most recent job. List all jobs, including part-time, temporary or volunteer positions you have held since age 16 or over the last ten (10) years, whichever is less. Attach a separate sheet if necessary. Employer: Employment Dates: From: To: Phone Number: Address: Job Title: Duties: Name of Supervisor: Supervisor Phone Number: Reason for Leaving: Employer: Employment Dates: From: To: Phone Number: Address: Job Title: Duties: Name of Supervisor: Supervisor Phone Number: Reason for Leaving: Employer: Employment Dates: From: To: Phone Number: Address: Job Title: Duties: Name of Supervisor: Supervisor Phone Number: Reason for Leaving: ---PAGE BREAK--- Page 7 of 16 Revised 6/13/22 Have you ever been active duty military? Yes No If yes, indicate the branch, rank, and dates of active duty: Total years of service: Most recent duty assignment/career field: Are you currently in the Military Reserves or National Guard? Yes No If yes, indicate the branch, career field, and total years of service: Have you ever been discharged or asked to resign from any position of employment? Yes No If yes, list the employer and explain the circumstances. Employer Circumstances Have you ever resigned after being informed that you would be terminated by any employer? Yes No If yes, list the employer and explain the circumstances. Employer Circumstances Have you ever received formal discipline from your employer? Yes No If yes, list the employer and explain the circumstances. Employer Circumstances ---PAGE BREAK--- Page 8 of 16 Revised 6/13/22 Have you ever been demoted, suspended, or fined by your employer? Yes No If yes, list the employer and explain the circumstances. Employer Circumstances Have you ever been investigated by your employer for sexual harassment or Equal Employment Violations which resulted in you being found in violation of any organization policies, regulations, rules, or any state or Federal Laws? Yes No If yes, list the employer and explain the circumstances. Employer Circumstances Have you ever been investigated by your employer for improper conduct or illegal activities which resulted in you being found in violation of any organization policies, regulations, rules, or any State or Federal Laws? Yes No If yes, list the employer and explain the circumstances. Employer Circumstances ---PAGE BREAK--- Page 9 of 16 Revised 6/13/22 List below every civil service or public agency competitive examination you have taken. Include any other law enforcement agencies or previous applications with the Monument Police Department. Attach additional sheets if more room is required. Agency Date of Examination Status If you were not employed by any of the above agencies, give reason, if known: RESIDENCE HISTORY Provide your residence history since the age of 18, or the last 10 years, whichever is less. From: To: Address: From: To: Address: From: To: Address: From: To: Address: From: To: Address: From: To: Address: ---PAGE BREAK--- Page 10 of 16 Revised 6/13/22 EDUCATIONAL HISTORY List all high schools, colleges, universities, trade, and business schools attended. Begin with the most recent. Name of School Street Address City and State Dates Attended From To Graduated Yes No Degree If you attended college, number of credits: What was your major? What was your minor? Type of Degree received? NOTE: Please provide a copy of your high school diploma or GED certificate. ---PAGE BREAK--- Page 11 of 16 Revised 6/13/22 CRIMINAL HISTORY/LEGAL ISSUES Have you ever been arrested, charged, questioned as an accused party, or convicted of a felony or misdemeanor, including court martial and military charges? (Omit Traffic Violations) Yes No If yes, complete the following (list incidents as a juvenile as well). Police Agency Crime Charged City and State Date Disposition of Case Have you ever been arrested, charged, or questioned in a domestic violence incident or any other crime which would prohibit you from possessing a firearm? Yes No If yes, explain in detail including dates and location: (Use back of this page if more space is needed). Dates Location Explanation Have you ever received deferred prosecution, deferred judgment or deferred sentencing for any offenses against municipal or county ordinances, or state/federal/military law? Yes No If yes, list dates, location, and explanation. Dates Location Explanation ---PAGE BREAK--- Page 12 of 16 Revised 6/13/22 TRAFFIC HISTORY Do you possess a valid driver’s license? Yes No From what State? License Number: Type of License (operator, chauffeur, etc.): Expiration Date: Have you ever been refused a driver’s license by any state? Yes No If yes, give date, location and reasons for each situation Date Location Reasons Was your license ever suspended, denied, or revoked? Yes No If yes, give date, location, and reasons: Date Location Reasons Have you ever been in a car accident (list all occurrences)? Yes No If yes, please explain. Have you ever been arrested for driving a vehicle while under the influence of alcohol or drugs? Yes No If yes, explain in detail to include the date of the violation, arresting enforcement agency, case number, and disposition: Date of Violation Arresting Agency Case # Disposition ---PAGE BREAK--- Page 13 of 16 Revised 6/13/22 Have you ever been issued a ticket for any driving violation, other than parking tickets? Yes No If yes, give date, location, and disposition. Date of Violation Charging Agency Charge Disposition List all states where you have been licensed to operate a motor vehicle in the last seven years? LIQUOR AND NARCOTICS Describe in your own words, your use of intoxicating liquors Have you ever used any form of drugs or narcotics, other than those prescribed by your physician? Yes No If yes, explain in detail including number of occurrences and date of last use: Have you ever used marijuana, prescribed or not? Yes No If yes, explain in detail including number of occurrences and date of last use: Have you ever sold or furnished drugs or narcotics to anyone? Yes No If yes, explain in detail including number of occurrences and date of last use: ---PAGE BREAK--- Page 14 of 16 Revised 6/13/22 ADDITIONAL INFORMATION Is there anything that may disqualify you as a candidate for the position of Police Officer or would prevent you from performing the official duties of the position? Yes No If yes, explain in detail: USE OF FIREARMS Would you be reluctant to use a firearm against another person if it was necessary in the performance of duty? Yes No If yes, explain in detail: OTHER Do you have any relatives currently working for the Monument Police Department? Yes No If yes, Name Are you a previous employee of the Monument Police Department? Yes No If yes, When? Reason for Leaving? ---PAGE BREAK--- Page 15 of 16 Revised 6/13/22 IMPORTANT, READ CAREFULLY before signing this application. I understand that my signature verifies I have read and understand the following information: I certify that statements, information and documents provided with regard to this application are true and complete. I understand that the application is the first examination of the employment process for a Monument Police Officer position. It will determine if I shall qualify for further consideration for employment. I understand that failure to submit a complete application packet or comply with procedures established for such application will automatically disqualify me from the current examination process without prior notification. I also understand any omissions, discrepancies, conflicting information, misleading statements, false information, or evidence of fraud or deceit in any manner connected with this application and subsequent testing will disqualify me from examination or will constitute grounds for discharge. I further understand that all information in this application packet is subject to verification and I authorize investigation of such as necessary for the Monument Police Department to arrive at an employment decision. I also understand that I will be expected to participate in a variety of examinations, including a job suitability examination and polygraph, and will undergo a thorough background investigation. The investigation will include criminal activity; employment and personal history; illegal activities, current/past financial status; and other areas deemed appropriate by the Monument Police Department. I understand that failure to keep the Monument Police Department informed of any changes to my address, phone number, and employment availability, shall be just cause for disqualification. I further understand that failure to keep any scheduled appointment shall be just cause for disqualification. Additionally, I am aware that all submitted documents will not be returned to be or retrieved from my file for any reason, thus I have submitted copies where applicable. ---PAGE BREAK--- Page 16 of 16 Revised 6/13/22 PERSONAL INQUIRY WAIVER STATE OF COLORADO, COUNTY OF EL PASO TO: I hereby authorize a Monument Police Officer or other authorized representative of the Monument Police Department’s Office bearing this release, or a copy of it, within two years of its date, to obtain copies of any information in your files concerning me, or information pertaining to my employment, including but not limited to documents concerning my work record, my reputation, my financial status, my credit status, all medical, physical, mental records, or reports, including all information of a confidential, or privileged nature, and photocopies of same, education, academic, achievement, attendance, athletics, personal history, background investigations, criminal investigations, polygraph examination, any and all internal affairs investigations, and disciplinary action, including any files which are deemed to be confidential, and/or sealed. I respectfully request and authorize you to furnish the Monument Police Department’s Office any and all information that you may have concerning me. This information is to be used to assist the Office in determining my qualifications and fitness for the position I am seeking with the Town of Monument. This release is executed with the full knowledge and understanding that the information is for official use of the Town of Monument. Consent is granted for the Monument Police Department’s Office to furnish the information described above to third parties in the course of fulfilling its official responsibilities. I further understand that I waive any right or opportunity to read or review any information provided in the background investigation report prepared by the Monument Police Department’s Office. I hereby release you and all your duly authorized agents, both individually, and collectively, from any and all liability for damage of whatever kind, which may at any time result to me, my heirs, or my assigns because of compliance with this authorization and request to release information, or any attempt to comply with it. I understand that I have the right to receive a copy of this authorization and acknowledge that I have received a copy. Applicant’s Printed Name Applicant’s Signature Date NOTE: A PHOTOCOPY REPRODUCTION OF THIS SIGNED REQUEST SHALL BE FOR ALL INTENTS AND PURPOSES AS VALID AS THE ORIGINAL. YOU MAY RETAIN THIS FORM IN YOUR FILES. Signed and sworn to before me this day of My commission expires: