2. The information contained in this application is considered private, except for your relevant test scores, job history, education and training, and work availability, and used only in conjunction with your possible employment. Please furnish complete information, as failure to provide the data required by this application may result in rejection of your application.

4. Personal

6. First Name
7. Last Name
9. Address1
11. Address2
13. City
14. State
15. Zip
17. Phone Number
18. Email Address

20. Education

22. Did you graduate from high school or receive a GED?

    1. Yes
    2. No
24. If under 18, state your age
26. High School (Name and Location)
27. Certificate/Degree
29. Vocational/Technical School (Name and Location)
30. Certificate/Degree
32. College/University (Name & Location)
33. Certificate/Degree
35. Other (Name and Location)
36. Certificate/Degree
38. If not enrolled in college currently, what are your future goals? (Law Enforcement related?)
40. If in school, how many hours per week are devoted to school?

42. Experience

    If relevant, list current professional registrations, license, or certificates you have. Medical or law enforcement related, first-responder, EMT, defensive tactics, firearms, driving, etc.

44. License/Certificate/Registration

    List any License/Certificate/Registration and the Date Issued and Date of Expiration

46. Employment History

    Please begin with your most recent or current employer.

48. Employment History #1
50. Company Name
51. Phone Number
53. Address1
55. Address2
57. City
58. State
59. Zip
61. Name of Supervisor
62. May we contact?

    1. Yes
    2. No
64. Job Title
65. Employed (month/year to month/year)
67. Work Hours/Days you work
69. Employment History #2
71. Company Name
72. Phone Number
74. Address1
76. Address2
78. City
79. State
80. Zip
82. Name of Supervisor
83. May we contact?

    1. Yes
    2. No
85. Job Title
86. Employed (month/year to month/year)
88. Work Hours/Days you work
90. Employment History #3
92. Company Name
93. Phone Number
95. Address1
97. Address2
99. City
100. State
101. Zip
103. Name of Supervisor
104. May we contact?

     1. Yes
     2. No
106. Job Title
107. Employed (month/year to month/year)
109. Work Hours/Days you work

111. Volunteer History

113. Volunteer History #1
115. Company Name
116. Phone Number
118. Address1
120. Address2
122. City
123. State
124. Zip
126. Name of Supervisor
127. Employed (month/year to month/year)
129. Hours Volunteered
130. May we contact?

     1. Yes
     2. No
132. Volunteer History #2
134. Company Name
135. Phone Number
137. Address1
139. Address2
141. City
142. State
143. Zip
145. Name of Supervisor
146. Employed (month/year to month/year)
148. Hours Volunteered
149. May we contact?

     1. Yes
     2. No
151. How did you hear about us?
153. Why are you interested in volunteering for the West St. Paul Police Department?
157. Certification*

     1. I agree

     By checking this box, I certify that the information contained in this application is correct, and I have not omitted or misstated any information. I understand that falsification or omission of information may disqualify me from further consideration for employment or result in immediate dismissal if I am hired and the information is discovered at a later date. I authorize the schools, prior employers, and volunteer organizations listed above to provide my record, reason for leaving and all other information they may have concerning me, and I release all parties from all liability or claims for damages whatsoever that may result from the release of the information.

159. Policy of Non-Discrimination

     The City of West St Paul does not discriminate on the basis of disability in the admission or access to, or treatment or employment in, its programs or activities. The City Administrator has been designated to coordinate compliance with the non-discrimination requirements contained in section 35.107 of the Department of Justice regulations. Information concerning the provisions of, and the rights provided under the Americans with Disabilities Act are available from the City Administrator.

161. Equal Employment Opportunity Statement

     The City of West St Paul prohibits discrimination on the basis of race, color, sex, creed, marital status, religion, national origin, age (18 and over), sexual orientation, disability, adherence to any political affiliation, status with regard to public assistance or criminal convictions, which are not related to the position you are applying for.

Leave This Blank:


163. 1. Receive an email copy of this form.
164. Email address

     This field is not part of the form submission.

165. Submit

* indicates a required field