Gulf Stream Police Department 	
246 Sea Road    Gulf Stream, FL.  33483
561·278·8611 FAX 61·276·2528 

                      POLICE OFFICER 
EMPLOYMENT APPLICATION PACKET
                                               
Completion of the Police Officer Employment Application Packet is the first step in the employment process.  The information on these forms will be used to judge your qualifications for the position of police officer.  Read all of the questions carefully and answer all questions completely and honestly.

You must complete this application packet yourself.  Type or print the forms using a ball point pen.  Do not leave any blank spaces.  If a question does not apply, write “DNA” in the answer space.  All information in this application is subject to verification.  Any false, misleading, or incomplete information will result in your application being eliminated from consideration.

This packet contains the following forms: 

•	Police Officer Employment Application
•	Waiver of Liability and Release Form
•	Credit Information Release Form
•	Pre-employment Drug Screen Consent Form
•	Police Officer Position Description
•	FDLE CJSTC 58 Form
•	Additional Items / Information Instructions

Return the entire packet to the address below:

Gulf Stream Police Department
246 Sea Road
Gulf Stream, FL  33483

	Office Use Only:  Date received _________________________________

                  Gulf Stream Police Department 	
246 Sea Road. Gulf Stream,   FL.  33483
561·278·8611 FAX 561·276·2528 

POLICE OFFICER EMPLOYMENT APPLICATION

                                                           Instructions

You must complete this application yourself. It may be printed in ink or typed.  Your ability to completely and honestly complete this application is part of the process to determine your suitability for employment.  If you intentionally leave out any information that might be detrimental to obtaining a job, such as past drug use or other crimes, it will automatically eliminate you from consideration for employment. The fact that you may have used drugs, committed a theft or another illegal act will not automatically eliminate you, but the omission of it during the application process will.  Once submitted, this application becomes the property of the Town of Gulf Stream.      

                                                     Basic Personal Information

Name:  

Last	                First	                                        Middle

Please list any other names that you have used: 

Home Address:
Street                                                   City	            State	           Zip
Social Security Number:                                                    E-mail address: 
Telephone: 
Home Number	Daytime Number	Cell Number

Number	State	Type

Driver's License: 

Place of birth: 
City	State	Country

Eligibility
1. Are you at least 21 years of age? 	Yes	    No

2. Do you have a legal right to work in the United States? (Check one)	U.S. Citizen ___

 Permanent Resident Status                                         Other (specify)

3. Are you a licensed Police officer in the State of Florida?	___ Yes __ No

4. If yes, when did you obtain your certification ? _____and
                Training Academy location

Address	City	State	Zip	Date

5. Has your FL Police officer's Cert. ever been suspended ?

__ Yes     	No

6. If yes, explain the circumstances on a separate sheet.

7.  Are you a commissioned/Certified Police Officer in another state of the U.S.?   _ Yes _ No

8. If yes, in which state did you receive your commission / Certification ? 	 	_

9. If yes, when and where did you obtain your Certification ?
           Training Academy Location

Address 	City	State	Zip	Date

10. Have you applied for a position with the Town before?	_ Yes _ No

11. If yes, when and previous position(s) applied for: 

Military Service

Please make copies of all applicable service records including any discharge papers and attach to this application.
Branch:  		Serial Number:

Date of service:   	 	

to   	_ 	Reserve Status: 	_

Type of discharge:  	 	If not honorable, explain: 	 	_

Selective Service Number: 	Classification: 		__ Are you a member of the Reserves or National Guard? 		_ Yes _ No
If yes, give unit, location, grade, and duty assignment: 
Unit

Location	Grade	Duty Assignment

Education

Please complete the information that applies and attach copies of your diplomas or copies of your course schedule and grades to the application.

If you did not complete high school, do you have a GED?	_ Yes	No

High School	Address	State	Degree	

COLLEGE I UNIV.				
GRADUATE SCHOOL				
OTHER				

Specialized Skills and Training

Do you speak another language other than English? _ Yes _ No 	Fluent? _ Yes _ No

If yes, please list:

Briefly list any computer skills you have. If you have copies of any certificates for computer training you have received, please attach them to the application:

Please list any social internet sites (Facebook, Twitter, Instagram personal blogs) that you have an active or past account with:

Briefly list any training or skills, including firearms, that would be of assistance in the job you are ap­
plying for. If you have any copies of certificates for any training, please attach them to the application:

Personal History

1.  Do you know of any reason that you could not pass a background check?     _ Yes  _ No

2.   Have you ever been fired or asked to resign from a job?  	_ Yes _  No

3.   Have you ever received disciplinary action from an employer?	_ Yes _  No

4.   Have you ever stolen from an employer?	_ Yes _  No

          5.  Have you ever falsified a police report?

6.   Have you ever accepted money not to report a crime?

_ Yes _ No  _  Yes _ No

7. Has any driver's license issued to you ever been suspended or revoked?

8. Have you ever used, sold, or otherwise handled in an illegal manner any controlled substance?
9. Have you ever been bonded?

         10. Have you ever been refused bond?

      Yes        No           Yes            No           

    Yes	No

Yes           No

If you answered yes to any of the questions listed above, please write a brief explanation for that question on a separate sheet.  List the question by number.  If you are interviewed, you will be asked about any "yes" answers.  Any "yes" answers will be closely examined during a background check.   A "yes" answer does not automatically eliminate you from consideration for employment. Your omission of these facts will automatically eliminate you from consideration.

Traffic, Civil Court, and Criminal Record

Please list your history of any traffic citations, any civil court actions in which you were or are a   defendant, any arrests, convictions, and court actions.   If additional space is needed, list on a separate sheet.

Type of case 	Jurisdiction	City, State
1.                                                                                                                                                                        

2.                                                                                                                                                                         

3.                                                                                                                                                                        

4.                                                                                                                                                                         

5.                                                                                                                                                                         

6.                                                                                                                                                                         

7.                                                                                                                                                                         

8.                                                                                                                                                                         

Family History
List all members of your and, if applicable, your spouse’s 
Immediate family. For each person give their name, address, relationship and date of birth. 

Include parents, step-parents, foster parents, guardians, brothers, sisters, children and step-children.

See attachment provided with the application:

Have you ever declared bankruptcy?

_ Yes _  No
If yes, give date and circumstances: 

Employment History

NOTICE:  Start with your current job, if employed, and list your past employment in reverse order. Include all employment from high school to the present.  Account for any time that you were unem­ ployed by stating the nature of your activities. If additional space is needed, list on a separate sheet.

Company: 							Position: 

FT 	PT

Address: 	City:  	

Dates from  	to  	_

State:

ZIP: 

Supervisor's Name:                                                                                        Telephone No.: 	_

Job Duties: 			 _
Reason for leaving: 	_

Company: 							Position: 

FT 	PT

Address: 	City:  	

Dates from  	to  	_

State:

ZIP: 

Supervisor's Name:                                                                                        Telephone No.: 	_

Job Duties: 			 _
Reason for leaving: 	_

Company: 							Position: 

FT 	PT

Address: 	City:  	

Dates from  	to  	_

State:

ZIP: 

Supervisor's Name:                                                                                        Telephone No.: 	_

Job Duties: 			 _
Reason for leaving: 	_

Company: 							Position: 

FT 	PT

Address: 	City:  	

Dates from  	to  	_

State:

ZIP: 

Supervisor's Name:                                                                                        Telephone No.: 	_

Job Duties: 			 _
Reason for leaving: 	_

Company: 							Position: 

FT 	PT

Address: 	City:  	

Dates from  	to  	_

State:

ZIP: 

 Supervisor's Name:                                                                                        Telephone No.: 	_

Job Duties: 			 _
Reason for leaving: 	_

Residences

List all residences where you have lived during the past five years.  Begin with your present address and work backwards. List the complete address including street number, street name, city, state, and zip code. If additional space is needed, list on a separate sheet.

					

					

ADDRESS 	CITY 	STATE 	ZIP CODE	DATES

Personal References
List six personal references that are not related to you. Do not use former or current employers. Be sure to include all of the information requested.  (Use attachment provided with application).

			

NAME 		ADDRESS, CITY STATE, ZIP CODE

AREA CODE& PHONE NUMBER

Remarks

Please tell us about yourself.  Include any awards, honors, licenses or certificates that you have   received.  What are your hobbies and interests?  You can also use this section to expound upon any answers to any questions on this application:

Please Read Carefully Before Signing This Application

I declare that the foregoing statements are true and correct to the best of my knowledge and belief.  I realize that falsification of any information on this application is grounds for disqualification.  I further understand that any misrepresentation or omission of facts upon this application will be sufficient cause for cancellation and/or separation from Town service if I have been employed.

                                                                  Signature of Applicant: 

     STATE OF FLORIDA
     COUNTY OF PALM BEACH

     The foregoing instrument was acknowledged before me on this ____________________

Day of                                                    , 20        by                                                                  ,_

Who has produced                                                          as identification and who did take an oath.

Signature of Notary

Print Name:                                                                 _______________________________

Title:                                                                             

My Commission Expires:                                              

(SEAL)

The Gulf Stream Police Department updates applicants at least once each year or as needed to fill vacancies. This is what will happen with your application.
1.  Your application is reviewed to ensure you meet the minimum qualifications for a police officer position and for accuracy, legibility, and completeness.
2.  When the application is received, you will receive notification of its acceptance
 by letter or phone.
                    Gulf Stream Police Department 	
246 Sea Road. Gulf Stream,   FL.  33483
561·278·8611 FAX 561·276·2528 

WAIVER OF LIABILITY AND RELEASE FORM

In consideration of the Gulf Stream Police Dept. and the Town of Gulf Stream, Fl., hereinafter referred to as the Agency processing my application for employment, I,                                                                                   hereby irrevocably agree to the following terms and conditions:               Full Name (typed or printed)

1.   The term "background investigation" as used in this document refers to any and all information and sources of information that the Agency, in its sole discretion, may deem necessary to obtain or contact, to determine my fitness as a candidate for employment with the Agency.

2.    I hereby release from liability and promise to hold harmless under any and all possible causes of legal action any officer, agent, or employee of the Agency who may conduct my background investigation.

3.    I hereby release from liability and promise to hold harmless under any and all possible causes of legal action, any and all person and entities who shall furnish any information or opinions to the officers, agents, or employees of the Agency who conduct my background investigation.

4.    I authorize any person or entity contacted by the Agency's officers, agents, or employees during the course of my background investigation, to furnish such officer, agents, or employees any information opinions they may have, and hereby expressly waive any and all legal privileges, the clergyman - penitent privilege, the husband-wife privilege, and the accountant- client privilege.

5.    I hereby release from liability and promise to hold harmless, under any and all possible causes of legal action, the political subdivision, the Agency or any of its officers, agents or employees for any statements, acts or omissions in the course of my background check.

6.   I expressly waive all of my legal rights and causes of actions to the extent that the Agency background check may violate or infringe upon these legal rights and causes of action.

7.   I expressly agree that I will never, under any circumstances, attempt to obtain the results of my background investigation as conducted by the Agency, realizing such information must of necessity remain confidential.

DO NOT SIGN BEFORE READING

This release from liability given by me to the political division, the Agency, its officers, agents and employees, and all others as mentioned above, shall apply to my right of action of any nature whatsoever that might accrue to myself, my heirs, or my personal representative.

Date:                                              _    Signature of Applicant: 

Date of birth:  	_	SSN:  		 	_

Driver's License Number and State:  
Date:  	 	_   Witnessed by:  	_

                  Gulf Stream Police Department 	
246 Sea Road. Gulf Stream,   FL.  33483
561·278·8611 FAX 561·276·2528 

CREDIT INFORMATION RELEASE FORM

Consumer Report Disclosure

By this document, the Town of Gulf Stream discloses to you that a consumer report may be obtained for employment purposes as part of the pre-employment background investigation and at any time, during your employment.   Please sign below to signify receipt of the foregoing disclosure.

Applicant Full Name (typed or printed) Applicant Signature
Date

Witness Signature

Date

Consumer Report Authorization

This document shall authorize the procurement of a consumer report by the Town of Gulf Stream as part of the pre-employment background investigation. If hired, this authorization shall remain on file and shall serve as an ongoing authorization for the City of Gulf Stream to procure consumer reports at any time during my employment period.

Applicant Full Name (typed or printed) Applicant Signature
Date

Witness Signature

                     Gulf Stream Police Department 	
246 Sea Road. Gulf Stream,   FL.  33483
561·278·8611 FAX 561·276·2528 

PRE-EMPLOYMENT DRUG SCREEN CONSENT

1.  I,                                                                                                 , as an applicant with the Town of 
Applicant Full Name (typed or printed)
Gulf Stream consent to allow my blood, breath and/or urine to be tested for drugs.
I further consent to allow the results  of such  testing  to be  released  to the Town of
Gulf Stream, Florida or it's authorized agents to representatives.

2.  I hereby release the Town of Gulf Stream and its employees from any action that may arise out of results of such tests or information being released to the Town of Gulf Stream.

3.  I understand that if I fail to sign and return this consent to the Town of Gulf Stream, Florida, my application will no longer be considered. I understand that if I test positive for any illegal substance, any offer of employment I have received will be withdrawn.

Applicant Signature

Date

Witness Signature

Date

                  Gulf Stream Police Department 	
246 Sea Road. Gulf Stream,   FL.  33483
561·278·8611 FAX 561·276·2528 

POLICE OFFICER POSITION DESCRIPTION

JOB TITLE: DEPARTMENT: DATE:
IMMEDIATE SUPERVISOR:

ESSENTIAL FUNCTIONS

Police Officer Police         

Police Sergeant

1. Community Patrolling Activities
A. Serves as a liaison officer within the community responding to non-criminal public concerns assuring for safety and the best public relations for the city.
B. Represents the department in continual interaction with various other social service agencies to combine all resources assuring for the best service to the community.
C. Establishes and maintains communication by the frequent use of personal contact with the community assuring for the best public relations for the city.
D. Assists the offenders in finding social service agencies available.

2. Patrol Related Activities
A. Attends daily briefing and obtains assignment assuring for professionalism.
B. Assists with patrolling the city, as needed, and conducts checks and monitors progress within the city.
C. Responds appropriately to notification of incident/accident reports assuring for timeliness,
professionalism, and for safety.
D. Completes reports and submits to sergeant as required, assuring for timeliness and accuracy. E. Looks for law violations that require action. Informs appropriate individual or takes action as appropriate. Does necessary follow-up as required.
F. Determines when traffic stops for motor vehicle code violations are necessary and takes appropriate action.
G. Responds to requests from immediate supervisor in an accurate, complete and timely manner.

3. Requests for Service Activities
A. Receives assignments and responds as requested, assuring for professionalism and the best public relations for the city.
B. Completes the required documentation of assignments as necessary assuring for accuracy and
timeliness.
C. Responds to radio announced incidents, make a determination regarding the emergency or non­ emergency nature of the incident. Coordinates with other units as needed. Prioritizes calls based on importance.
D. Responds appropriately and notifies dispatcher of arrival on scene. Takes appropriate enforcement or control action as required assuring that department procedures are followed and assures for officer
and public safety.
E. Notifies dispatcher of status and begins investigation of offense.
F. Locates, gathers, and preserves possible evidence and maintains chain of custody in accordance with department policies.
G. Completes investigation, makes determination regarding enforcement action required and completes reports and documentation as required for timeliness accuracy. 
                  
H. If needed, makes arrest and handles prisoners assuring for officer and public safety and assuring that department procedures are followed.
I.  Conducts and completes any required follow-up activities.

4. Other Patrol Activities
A. Conducts nuisance violations and parking enforcement activities assuring for safety, professionalism and the best public relations for the city.
B. Maintains an awareness of persons, who have outstanding warrants, maintains vigilance for such persons and serves warrants as required assuring for safety and professionalism, and for following pre­ scribed policies and procedures.
C. Assists with emergency animal control and animal related complaints.
D. Responds to requests for assistance from other agencies assuring for professionalism and for       adherence to department policies and procedures.
E. Maintains and safeguards vehicles and other department issued supplies and equipment.
F. Learns and maintains an awareness of all applicable department practices, policies, procedures, laws and rules.
G. Learns the geography and locations within the city.
H. Spots trouble areas for the city utilities (water leaks, traffic light problems, etc.} I. If necessary, acts as supervisor when the sergeant is absent.

5. Jail Related Duties
A. Books prisoners assuring that all laws, policies and regulations are followed and the safety of self, the prisoner and others is maintained. Enters all information into the appropriate data bases.
B. Completes all required documentation in accordance with department procedures (fingerprinting, property inventory, photographing, etc.}
C. Files prisoner information in the appropriate location assuring for accuracy. 

6. Training and Court Duties
A. Attends training and continuing education to maintain certifications.
B. Develops training sessions for the police department personnel based on specialization areas. C. Prepares documents and evidence for court proceedings when necessary.
D. Testifies and presents evidence before the court when subpoena received.

    Performs other related duties as required.

This job description in no way states or implies that these are the only duties to be performed by the employee occupying the position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties as assigned by their supervisor; subject to reasonable accommodations.

WORK ENVIRONMENT
•	Exposure to weather and temperature extremes.
•	Average exposure to heights.
•	Above average exposure to work safety hazards.
•	Average amount of overtime/extended work hours required.
•	Above average exposure to dust.
•	Above average exposure to loud noises. 
     •	Above average exposure to darkness.
      •	Above average exposure to cramped spaces.

PHYSICAL EFFORT
•	Above normal physical mobility: movement from place to place on the job, considering distance and speed.
•	Normal physical agility: ability to maneuver body while in place.
•	Normal physical strength to handle office materials.
•    Normal physical strength to handle 150 lb. objects, considering frequency.
•	Normal dexterity of hands and fingers.
•	Normal physical balance: Ability to maintain balance and physical control.
•	Normal coordination, including eye/hand, hand/foot, etc.
•	Normal endurance.

KNOWLEDGE REQUIREMENTS
•	Completed high school diploma or equivalent.
•	Valid driver’s license.
•	Possess and maintain certification as a Police Officer from the Florida Department of Law Enforcement.
•	Must be at least 21 years of age, US citizen or authorized to work in the US.
•	Non-convicted felon.
.
MENTAL EFFORT
•	Normal concentration/intensity: prolonged mental effort with limited opportunity for breaks.
•	Average memory, considering the amount and type of information.
•	Above normal complexity of decision making.
•	Normal time pressure of decision making.
•	Normal analytical thinking.
•	Normal conceptual thinking.

COMMUNICATION
•	Above-average verbal communication.
•	Above-average written communication.
•	Above-average non-verbal communication.

SENSORY ABILITIES
•	Normal ability to see,
•	Normal ability to distinguish colors and shades.
•	Normal ability to hear.
•	Normal ability to smell.
•	Normal sense of touch.

MINIMUM TRAINING AND EXPERIENCE

High school diploma or equivalent; supplemented by previous experience and/or training that includes law enforcement, administration, supervisory, and investigative work; or any equivalent combination of education, training, and experience which provides the requisite knowledge, skills, and abilities for this job. 

SPECIAL REQUIREMENTS
Must possess and maintain certification as a Police Officer from the Florida Department of Law Enforcement.
Must be eligible to carry a weapon

This job description has been approved by the Town Manager 
____________________________________________________
Employee signature below constitutes employee's understanding of the requirements, essential functions and duties of the position.
Employee______________________________________________________ Date ____________
The Town of Gulf Stream is an Equal Employment Opportunity Employer. In compliance with the Americans with Disabilities Act, the Town of Gulf Stream will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer. The Town does not discriminate  in employment  opportunities  or practices on the basis of race, color, religion, sex, national origin, age, disability, marital status, or any other characteristic protected by law.