Application For Employment - Town Of Selbyville Police Department Page 3

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List Professional, Trade, Business, or civic activities and offices held. You may exclude organizations which indicate race, color, religion, gender,
national origin, disabilities or other protected status.
State any additional information you feel may be helpful to us in considering your application.
REFERENCES
Please list three references.
Full Name
Telephone #
Address
email
Full Name
Telephone #
Address
email
Full Name
Telephone #
Address
email
APPLICANT’S STATEMENT
I certify that my answers are true and complete to the best of my knowledge.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an
employment decision.
This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be
considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
In the event of employment, I understand that false or misleading information given in my application or interview (s) may result in
discharge. I understand also, that I am required to abide by all rules and regulations of the employer.
Signature
Date

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