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SALEM POLICE DEPARTMENT 95 Margin Street Salem, MA 01970 Constable Application Process – Criminal Offender Record Information (CORI) As a prospective Constable making application through the City of Salem, I understand that a CORI check will be Print Name submitted for my personal information to the DCJIS and a background check of my moral character and integrity will be conducted in order to comply with the standards of the Salem City Ordinance C. 32, s. 19. I hereby acknowledge and provide permission to the Salem Police Department to submit a CORI check for my information to the DCJIS and to conduct a background check. This authorization is valid for six months for the processing of my application for Constable. I also understand that I may withdraw this authorization at any time by providing the Salem Police Department with written notice of my intent to withdraw consent to a CORI check and the background investigation. FOR APPOINTMENT PURPOSES: The Salem Police Department may conduct, on behalf of the City of Salem, a check of my CORI for the purposes of establishing that I am a qualifying candidate for appointment as a Constable. I understand that this information and any background investigation will be shared with the Mayor who is the appointing authority for all Constables making application through the City of Salem. By signing below, I provide my consent to a CORI check and background investigation and affirm that the information provided in my application for Constable is true and accurate. Signature of CORI subject Date