INSTRUCTIONS: Applicant must complete application accurately. All statements are subject to verification. If writing space provided is inadequate, use an additional sheet at the end of the application and identify additional information by page number and question number. Use the term “N/A” if the question does not apply. Be certain to list the area code for each telephone number requested.
E-Mail application to: Kcarteryoung@villageofcrete.org
List the various schools you have attended and other information requested
List the names of five adults not related to you and not former employers who have known you for a period of preferably more than five years. All persons to whom you refer will be asked to appraise your character, ability, experience, personality and other qualities.
I hereby certify that there are no willful misrepresentations, or falsifications in this questionnaire, and all my answers are true and correct to the best of my knowledge and belief.
It is understood and agreed upon that any misrepresentation or omission by me on this application will be sufficient cause for cancellation of this application and/or separation from the employer’s service if I have been employed.
I give the employer the right to investigate all references and to secure additional information about me. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.
The undersigned fully understands that part of the testing process may require taking a polygraph examination. This examination may cover the following areas:
The undersigned acknowledges that part of the testing process requires taking a psychological examination, a medical examination, and a drug-screening test; to determine fitness and recommendation for a position in law enforcement. The drug test is to detect the presence or absence of habit forming drugs, including, but not limited to, marijuana, cocaine, and heroin.
I acknowledge that the results of the above tests will be considered by the Village of Crete Fire and Police Commission in its evaluation of my application, and hereby consent both to the testing and such use of the results as may be reasonably necessary in the evaluation of my application.
The undersigned hereby releases, remises, and discharges the Village of Crete, Illinois, a municipal corporation, their Fire and Police Commission, its officers, servants, agents, and employees, of and from any and all injuries, losses, and damages to my person that shall have been caused, or at any time may arise as a result of the examinations for the position of Patrol Officer conducted by the Village of Crete. The intention hereof being to completely, absolutely, and finally release said municipality, their Fire and Police Commission, its officers, servants, agents, and employees, of and from any and all liabilities arising wholly or partially from the cause aforesaid.
The undersigned fully understands, and agrees, that all tests and results thereof, become the property of the Fire and Police Commission of the Village of Crete. Additionally, the undersigned also understands and acknowledged that all said testing materials, and the results thereof, are not subject to review.
I hereby agree toabide by all the rules and regulations of the Fire and Police Commission of the Village of Crete, Illinois during and after all examination programs.
I authorize and empower the Village of Crete, the Crete Fire and Police Commission, and any consumer reporting agency, or other outside service company engaged by said Commission for the purpose, now or subsequently, to obtain, prepare, use and furnish information concerning my current and former employment, education, credit, general reputation, health, personal characteristics, and mode of living, through correspondence or personal interview with neighbors, friends or associates, or others with whom I am acquainted, or who may have knowledge concerning any of the above items.
I acknowledge that the results of the above investigation will be considered by the Crete Fire and Police Commission in its evaluation of and my application, and hereby consent both to the investigation and such use of the results as may be reasonably necessary in the evaluation of my application.
The undersigned fully understands and agrees that the results of the investigation become the property of the Fire and Police Commission of the Village of Crete, Illinois. Additionally, the undersigned also understands and acknowledges that said results thereof are not subject to review.
I hereby agree to abide by all the rules and regulations of the Fire and Police Commission of the Village of Crete, Illinois during and after all examination programs.
TO WHOM IT MAY CONCERN:
I respectfully request that you forward to the Crete Police Department any and all information that you may have concerning my work record, my reputation, or me.
In addition, please provide any information that may appear in my personnel file.
This information is used to determine my qualifications and fitness for the position that I am seeking with the Crete Police Department.
I hereby release you, and/or your employer, from any liability and damage of whatsoever nature connected with the release of the information stated above.