Phone Number

Email Address

Birth Date

Best Email Address for us to reach you at

City

Adress

Social Security Number

Name

State

Position Applied For

Have you ever worked for the Town of Port Royal? Have you ever worked for the Town of Port Royal? Yes No

If Yes, when?

Are you related to anyone currently employed by the Town of Port Royal? Are you related to anyone currently employed by the Town of Port Royal? Yes No

If yes, explain.

Are you a US Citizen Are you a US Citizen Yes No

If No, are you authorized to work in the U.S? If No, are you authorized to work in the U.S? Yes No

Have you ever been licensed in another state? Have you ever been licensed in another state? Yes No

If yes, what were the state(s) and license number(s)

Have you ever been arrested for anything other than a minor traffic offense? Have you ever been arrested for anything other than a minor traffic offense? Yes No

If yes, list the charge(s) and disposition

Have you ever applied with this or any other law enforcement agency? Have you ever applied with this or any other law enforcement agency? Yes No

If yes, list the agency and your current status in the hiring process

High School attended

Did you graduate? Did you graduate? Yes No

College Attended

Did you graduate? Did you graduate? Yes No

Did you serve in the United States Military Did you serve in the United States Military Yes No

If so, what branch?

What type of discharge did your receive?

If other than Honorable, explain:

By submitting this application I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. By submitting this application I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I agree I disagree

I understand that, by submitting this application, I may receive correspondence from Guardian, a third-party background verification company. I understand that, by submitting this application, I may receive correspondence from Guardian, a third-party background verification company. I understand