Police Officer Applicant Background Questionnaire - Sierra Vista Police Department Page 7
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2418.
PERSONAL REFERENCES: List at least three people who have known you for over one year, excluding relatives or former employers, who
can answer questions concerning your past conduct and character as it applies to your meeting the minimum standards for appointment.
Home
Work
Years
Name
Street Address, City, State, Zip Code
Telephone
Telephone
Known
No.
No.
19. EXCLUDING FAMILY MEMBERS, LIST ALL PERSONS YOU HAVE LIVED WITH DURING THE PAST FIVE YEARS.
Use the Continuation Sheet if
necessary.
Home
Name
Street Address, City, State, Zip Code
Relationship
Telephone No.
20.
FAMILY REFERENCES: List all immediate relatives, (i.e., parents, siblings, spouse, ex-spouse(s) and all
children).
Use the Continuation Sheet
if
necessary.
Name
Relationship
Age
Street Address, City, State, Zip code
Telephone No.
AGENCY VERIFICATION:
INITIALS:
DATE:
INITIALS:
Personal References Contacted and Results Documented
Residences and Family References Listed
AZ POST Form PH (Sept. 2015) Page 4 of 10
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