PPSO Employment Application

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Proof of age will be required upon employment. Are you at least 18 years of age? Proof of age will be required upon employment. ","name":"Are-you-at-least-18-years-of-age","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"text","required":true,"label":"Street Address","name":"Street-Address","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"City","name":"City","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"select","required":true,"label":"State","name":"State-of-residence","className":"col-md-6 col-lg-3","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of 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Confirmation","name":"email-confirmed","className":"col-lg-4"},{"type":"text","required":true,"label":"Drivers License Number","name":"Drivers-License-number","className":"col-md-6","subtype":"text"},{"type":"select","required":true,"label":"Drivers License Issuing State","name":"Drivers-License-Issuing-State","className":"col-md-6","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"radio-group","label":"Do you have any relative(s) currently employed or were employed within the last year by the Sheriff's Office?","inline":true,"name":"Do-you-have-any-relatives-currently-employed-or-were-employed-within-the-last-year-by-the-Sheriffs-Office","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"paragraph","subtype":"p","label":"If yes to above question, please list the relative(s) name and division in which they were employed.","className":"d-block"},{"type":"text","label":"Relative First Name","name":"Relative-First-Name","className":"col-lg-4","subtype":"text"},{"type":"text","label":"Relative Last Name","name":"Relative-Last-Name","className":"col-lg-4","subtype":"text"},{"type":"text","label":"Relative Employment Division","name":"Relative-Employment-Division","className":"col-lg-4","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h4","label":"Other Names Used","className":"d-block"},{"type":"text","label":"First Other Name Used","description":"Examples: maiden name, former name(s), alias(es), or nickname(s)","name":"First-Other-Name-Used","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Circumstance for First Other Name","description":"Ex: Maiden name, Reason for name 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col-lg-3","subtype":"text"},{"type":"date","label":"Date Started Using Second Other Name","description":"Date began using name, excluding maiden names","name":"Date-started-using-second-other-name","className":"col-md-6 col-lg-3"},{"type":"date","label":"Date Stopped Using Second Other Name","description":"Date stopped using name.","name":"Date-stopped-Using-Second-Other-Name","className":"col-md-6 col-lg-3"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Background Information","className":"d-block"},{"type":"text","required":true,"label":"City of Birth","name":"City-of-Birth","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"County of Birth","name":"County-of-Birth","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"select","required":true,"label":"State of Birth","name":"State","className":"col-md-6 col-lg-3","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","required":true,"label":"Country of Birth","name":"Country-of-Birth","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<b>NOTE:</b> Original or Certified Copy of Birth Certificate must be brought in upon interview.","className":"d-block"},{"type":"radio-group","label":"Are you a US Citizen?","inline":true,"name":"Are-you-a-US-Citizen","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"paragraph","subtype":"p","label":"<b>If naturalized, please provide:</b>","className":"d-block"},{"type":"date","label":"Date of Naturalization","name":"Date-of-naturalization","className":"col-md-6 col-lg-3"},{"type":"text","label":"Place of Naturalization:","name":"Place-of-Naturalization","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Issuing Court:","name":"Issuing-Court","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Naturalization Number:","name":"Naturalization-Number","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"file","label":"Attach your Naturalization Certificate if you were born outside of the United States.","name":"Naturalization-Certificate-Upload","subtype":"file","multiple":true,"className":"d-block"},{"type":"radio-group","required":true,"label":"Marital Status","inline":true,"name":"Marital-Status","className":"d-block","values":[{"label":"Married","value":"Married"},{"label":"Divorced","value":"Divorced"},{"label":"Separated","value":"Separated"},{"label":"Widowed","value":"Widowed"},{"label":"Never Married","value":"Never Married"}]},{"type":"radio-group","required":true,"label":"Have you ever applied for a Passport?","inline":true,"name":"Have-you-ever-applied-for-a-passport","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"text","label":"Passport Number","name":"Passport-Number","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Height","name":"Height","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Weight","name":"Weight","className":"col-lg-4","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Residences","className":"d-block"},{"type":"paragraph","subtype":"p","label":"Actual places of residence for the past 10 years - list chronologically all addresses, including residences while at school and/or in military. For college on-campus residences, give dormitory name, city, and state. If residences in military service cannot be shown as street address, indicate complete military unit designation and location by city and state. If post office box, give location of post office.","className":"d-block"},{"type":"date","required":true,"label":"Date Moved to First Residence","name":"Date-Moved-to-First-Residence","className":"col-md-6"},{"type":"date","required":true,"label":"Date Left First Residence","name":"Date-Left-First-Residence","className":"col-md-6"},{"type":"text","required":true,"label":"Street Address of First Residence","name":"Street-Address-First-Residence","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"City of First Residence","name":"City-of-First-Residence","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"select","label":"State of First Residence","name":"State-of-First-Residence","className":"col-md-6 col-lg-3","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of 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Residence","name":"Date-Left-Second-Residence","className":"col-md-6"},{"type":"text","label":"Street Address of Second Residence","name":"Street-Address-of-Second-Residence","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"City of Second Residence","name":"City-of-Second-Residence","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"select","label":"State of Second Residence","name":"State-of-Second-Residence","className":"col-md-6 col-lg-3","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North 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amphetamines, heroin, steroid, opiates, barbiturates, benzodiazepine, synthetic narcotic, designer drug, or any drug of a similar nature?","inline":true,"name":"Have-you-ever-illegally-experimented-with-or-used-any-narcotic-or-controlled-substance-such-as-but-not-limited-to-cannabinoids-synthetic-cannabinoids-PCP-hallucinogen-methaqualone-hashish-cocaine-LSD-amphetamines-heroin-steroid-opiates-barbiturates-benzodiazepine-synthetic-narcotic-designer-drug-or-any-drug-of-a-similar-nature","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"text","required":true,"label":"Drug Name","name":"Drug-Name","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"How was the drug used?","name":"How-was-the-drug-used","className":"col-lg-4","subtype":"text"},{"type":"date","label":"Date drug was last used or experimented 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Because of this, are you aware of any information about yourself or any person with whom you are or had been closely associated (including relatives, roommates, etc.) which might tend to reflect unfavorably on your reputation, morals, character or ability?","inline":true,"name":"I-understand-an-investigation-will-be-conducted-on-all-of-the-information-listed-on-this-application-Because-of-this-are-you-aware-of-any-information-about-yourself-or-any-person-with-whom-you-are-or-had-been-closely-associated-including-relatives-roommates-etc-which-might-tend-to-reflect-unfavorably-on-your-reputation-morals-character-or-ability","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"textarea","label":"If yes, provide your version or explain fully any such incident.","name":"If-yes-provide-your-version-or-explain-fully-any-such-incident","subtype":"textarea","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"By entering my name in the box below, I am certifying that I have fully read and understand the above certifications. 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