Notice Of New Appointment For Law Enforcement - State Of New Jersey printable pdf download

Division of Criminal Justice

State of New Jersey

Police Training Commission

Notice of New Appointment

P.O. Box 085

Trenton, NJ 08625

for Law Enforcement and

Phone 609-984-0960

Corrections Officers

Fax 609-984-4473

Completion of this form is required whenever a law enforcement (or corrections) officer is appointed (hired)

Please type or legibly print (in ink) all required information

Mail or fax this notice to the PTC within 30 days of the appointment date

Identification Information

1. Social Security Number

2. Name

(Last)

(First)

(M)

suffix

3. Birth date

4. Gender

5. Maiden name or any previous name (Last)

(First)

(M)

Suffix

Male

Female

6. Race/Ethnicity (mark the box that best describes the applicant’s race/ethnicity

7. Education (Mark highest level completed)

American Indian or

Native Hawaiian or

Bachelor’s

Master’s

Filipino

Grade 11

Alaskan Native

Other Pacific Islander

Diploma

Degree

Hispanic or

Grade 12,

Associate

Asian

White

Law

Latino

no diploma

Degree

Black or African

Some College -

Other

GED

Doctorate

American

credits completed:

Appointment Information

8. Employing Agency Name

9. County

10. Employing Agency ORI

11. Job Title Code

12. Date of Appointment (mm/dd/yyyy)

13. If Civil Service, date of test (mm/dd/yyyy)

N J

14. Attestation of reporting official

I attest that the information provided on this form is true and correct and is based on my personal knowledge or inquiry. The personnel records of this

agency substantiates the information on this form.

Signature of department head or authorized designee

Full name and title (type or print legibly)

Date

Phone

Job Title Codes

Arson Investigator

AINV

Investigator, Dept. of Corrections Internal Affairs

INVC

Auxiliary Police Officer

AUXP

Juvenile Corrections Officer

JCO

Campus Police Officer

CAMP

Juvenile Detention Officer

JDO

Chief Warrant Officer

CWO

Juvenile Parole Officer

JPO

Class 1 Special Law Enforcement Officer

SLE1

Juvenile Residential & Day Program Youth WorkerJRDP

Class 2 Special Law Enforcement Officer

SLE2

Municipal Police Officer

Conrail Police Officer

RAIL

New Jersey State Police

NJSP

County Airport Security Officer

AIRP

NJ Transit Rail Police Officer

RAIL

County Corrections Officer

CCO

Other

OTHR

County Detective

CDET

Parole Officer

PARL

County Investigator

CINV

Security Officer in Housing Authorities

HOUS

County Park Police Officer

Sheriff's Investigator

SHRI

County Park Ranger

CPR

Sheriff's Officer

County Police Officer

SPCA Officer

SPCA

Delaware River Port Authority Police

DRPA

State Conservation Officer

SCON

Department of Defense Police Officer

DEFE

State Corrections Officer

SCO

Dept. of Human Services Police Officer

HSER

State Investigator

SINV

Deputy Conservation Officer

DCO

State Park Ranger

SPR

Deputy Sheriff

DSHE

PTC 3-NONA Rev 6/15/04

Notice Of New Appointment For Law Enforcement - State Of New Jersey

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