Letter of Instructions to Applicants for the Position of POLICE OFFICER OPENING AND ELIGIBILITY LIST FOR THE CITY OF KAUKAUNA Deadline for Receipt of Completed Applications Wednesday, January 10, 2018 Thank you for your interest in a Police Officer position with the City of Kaukauna. Materials in this packet will tell you more about the position, how to make formal application, and requirements each applicant must satisfy to be eligible for placement. To aid you in filling out the application materials, we would offer these suggestions: 1. Carefully read the position description and position qualifications included in the application packet. Please be sure the Application for Employment form that you complete and return has information that shows you meet the qualifications described. You may also enclose any materials that help establish your qualifications for the position. 2. Complete and return the Equal Opportunity Information form and Diversified investigations, llc, Background Check forms. 3. Complete the Application for Employment form. Read and sign the statement at the bottom of the last page. Completed applications should be delivered or addressed to: HR DIRECTOR City of Kaukauna 144 W. Second Street Post Office Box 890 Kaukauna, WI 54130-0890 COMPLETED APPLICATIONS MUST BE RECEIVED BY 4:30 P.M. ON WEDNESDAY, JANUARY 10, 2018. AN EXCEPTION SHALL BE MADE FOR APPLICATIONS WHICH ARE MAILED AND POSTMARKED NO LATER THAN MIDNIGHT ON WEDNESDAY, JANUARY 10, 2018. At some point during the process leading to the appointment, it may be necessary to disclose the name of applicants under consideration, their address, and current employer. The possible disclosure of this information is made necessary by provisions in the Wisconsin Public Records Law and the interpretation of these provisions by legal counsel and the courts as they apply to information made available to units of government by prospective employees. Other information you provide will, normally, not be made available except to officials involved in the screening, testing, and selection process. If you have further questions, write to the address listed above or call Human Resources at (920) 766-6375. DV 1
This is a Kaukauna Police Department application and is not affiliated with any other agency. KAUKAUNA POLICE DEPARTMENT Employing Agency APPLICATION FOR EMPLOYMENT AS LAW ENFORCEMENT NOTICE: Application must be typewritten or clearly printed in ink. All questions must be answered, if applicable. If not, indicate NA (not applicable). Applications which are incomplete or illegible will not be considered. If space provided is insufficient for complete answers or you wish to furnish additional information, attach sheets of the same size as this application and number answers to correspond with questions. in Full (Last, First, Middle) 1. PERSONAL INFORMATION Drivers License Number Address (Apartment, Street, P.O. Box) Home Telephone Number ( ) City State Zip Code Work Telephone Number ( ) Are you over the age of 18? Yes No Are you a United States citizen? Yes No Do you have a valid Wisconsin driver's license? Yes No Have you ever been convicted of a felony? Yes No If yes, please attach a separate sheet giving full information? Do you have a valid driver's license from another state? Yes No If yes, which state? Have you completed at least 60 college credits? Yes No Date of completion: Have you completed the basic training hours required by the Law Enforcement Standards Board? Yes No Date of completion: IMPORTANT: Administrative Rule LES 2.01(1)(e) requires that an applicant possess either a two-year Associate Degree or 60 college level credits, or meet the standard within the first five years of employment. The Law Enforcement Standards Board may waive up to 30 credits upon documentation of writing, problem solving, and other communication skills. [Waiver forms available via the Department of Justice, Training and Standards Bureau, P.O. Box 7070, Madison, WI 53707-7070, 608/266-8800.] 2. EDUCATION Dates of School Location From To Course Pursued Degree, Diploma, or Credits Earned High Schools College Graduate School List any scholarships, apprenticeships, licenses, certifications, membership in professional organizations or other information you believe should be considered in evaluating your qualifications. 2
3. EMPLOYMENT Begin with current or most recent employer. List chronologically all employment, including summer and part-time employment while attending school. All time must be accounted for. If unemployed for a period, provide dates. To furnish additional employment information, attach sheets of the same size and format as this application. and Address of Employer Dates Position and Kind of Work Street City, State Supervisor's /Telephone: From Full-Time Part-Time To May we contact the employer/supervisor? Yes No Annual Salary/Wages: Reason for Leaving Street City, State Supervisor's /Telephone: From Full-Time Part-Time To May we contact the employer/supervisor? Yes No Annual Salary/Wages: Reason for Leaving Street City, State Supervisor's /Telephone: From Full-Time Part-Time To May we contact the employer/supervisor? Yes No Annual Salary/Wages: Reason for Leaving Street City, State Supervisor's /Telephone: From Full-Time Part-Time To May we contact the employer/supervisor? Yes No Annual Salary/Wages: Reason for Leaving 3
Branch of Service Month/Year Served From To 4. MILITARY SERVICE Active Duty or Reserve Highest Grade Skill Specialty or Primary Duty List special schools attended/skills acquired during military service. 5. REFERENCES Give three references (not relatives, or present employer; avoid listing members of the clergy). Number of Years Acquainted Address City/State/Zip Telephone Number ( ) Position/Title/Profession Number of Years Acquainted Address City/State/Zip Telephone Number ( ) Position/Title/Profession Number of Years Acquainted Address City/State/Zip Telephone Number ( ) Position/Title/Profession 6. GENERAL PLEASE ANSWER THE FOLLOWING. For questions A-C, attach no more than one additional page for each answer. A. Why have you chosen to apply for this position? B. Discuss things you have done which have contributed to your life experience. Remember to include information regarding volunteer work with civic, school, or professional organizations. Be specific about names and dates. C. Why do you believe you could relate to and/or work with people of different races, sexes, cultures, ages, socio-economic groups, and educational levels? 4
APPLICANT PLEASE READ CAREFULLY AND SIGN BELOW Information provided and statements made as part of this application may be grounds for not employing you or for dismissing you after you begin work. All information provided and statements made are subject to verification. CERTIFICATION ALL INFORMATION PROVIDED AND STATEMENTS MADE BY ME AS PART OF THIS APPLICATION, OR AS PART OF ANY ADDITIONAL INFORMATION PROVIDED IN SUPPORT OF THIS APPLICATION, ARE COMPLETE, CORRECT, AND TRUE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT IF I AM EMPLOYED, FALSE INFORMATION PROVIDED OR FALSE STATEMENTS MADE AS PART OF THIS APPLICATION MAY BE CONSIDERED AS CAUSE FOR DISMISSAL. I ALSO UNDERSTAND, AS REQUIRED BY CITY ORDINANCE, THAT ANYONE EMPLOYED FULL-TIME BY THE CITY OF KAUKAUNA AS A REGULAR EMPLOYEE MUST LIVE WITHIN THE DEFINED RESIDENCY AREA WITHIN THE TIME ESTABLISHED FOR THE APPLICABLE WORK AGREEMENT. Applicant's Signature Date Signed Under the provisions of section 19.36, Wisconsin Statutes, I request that my identity as an applicant for the position of Police Officer not be revealed without my consent as indicated on application or until required under law. Applicant's Signature Date Signed 07/08
Wisconsin Department of Justice Law Enforcement Standards Board DJ-LE-305, Rev. 8/00 AUTHORIZATION FOR RELEASE OF INFORMATION (For official use only, not to be released to unauthorized persons) I hereby empower an employee of the KAUKAUNA POLICE DEPARTMENT or other authorized representative thereof bearing this release to obtain information and records, within one year of this release, pertaining to me from any or all of the following sources: 1. Municipal, State, or Federal law enforcement agencies 2. Selective Service System 3. Any banking institution 4. Any place of business (for purposes of obtaining credit or employment data) 5. Credit rating bureaus or institutions 6. Any previous employer 7. Present employer 8. Any school, college, university, or other educational institution 9. Any law enforcement or jail officer Exceptions to this blanket authorization 1. Any medical information in the possession of any source named above until subsequent to a conditional offer of employment (per Americans With Disabilities Act). 2. 3. This release is executed to authorize the KAUKAUNA POLICE DEPARTMENT, as a prospective employer, to obtain the above information. It is understood that said information shall be used only in consideration of my employment and shall not be further disseminated for any purpose. Date Signature - Full Address - Street and Number City State Zip Witness: Signature
CONFIDENTIAL EQUAL EMPLOYMENT OPPORTUNITY INFORMATION City of Kaukauna The City of Kaukauna is an equal opportunity employer. The Federal government requires the City to periodically compile and report data on applicants and employees. This form helps the City collect the needed data. As completed employment applications are received, this form is removed and kept separate from other application materials. City officials involved in making hiring decisions do not have access to the information you provide nor will information you provide be used in making hiring decisions. Your cooperation will be appreciated. SOCIAL SECURITY NUMBER: - - CITY/VILLAGE/TOWN: DATE OF BIRTH: / / SEX: MALE FEMALE POSITION APPLIED FOR: DATE OF APPLICATION: / / ETHNIC CATEGORY (Check one): AMERICAN INDIAN OR ALASKAN NATIVE. All persons having origins in any of the original peoples of North America. ASIAN or PACIFIC ISLANDER. All persons having origins in any of the original peoples of the Far East, Southeast Asia or the Pacific Islands. This includes, for example, China, Japan, the Philippine Islands, and Samoa. Also, persons from the Indian subcontinent including people with national origins from Bangladesh, Bhutan, India, Nepal, Pakistan, Sukkim, and Sri Lanka. BLACK (not of Hispanic origin). All persons having origins in any of the Black racial groups. HISPANIC. All persons of Mexican, Puerto Rican, Cuban, Central and South American or other Spanish culture regardless of race. WHITE (not of Hispanic origins). All persons having origins in any of the peoples of Europe, North Africa or the Middle East. SPECIAL CATEGORY: Do you wish to identify yourself as: A QUALIFIED HANDICAPPED INDIVIDUAL who (1) has a physical or mental impairment which substantially limits one or more of a person's major life activities, or (2) has a record of such impairment, or (3) is regarded as having such impairment, and (4) is capable (qualified of performing a particular job with reasonable accommodation to his or her handicap? A QUALIFIED DISABLED VETERAN who (1) is entitled to disability compensation under laws administered by the U.S. Veterans Administration for disability rated at 30% or more, or (2) whose discharge or release from active duty was for a disability incurred or aggravated in the line of duty, or (3) is capable (qualified) of performing a particular job with reasonable accommodation to his or her ability? A VIETNAM ERA VETERAN who actively served for more than 180 days, any part of which occurred between August 5, 1964, and May 7, 1975, and was released with other than a dishonorable discharge, or was released from such active duty for a service-connected disability and was discharged/released within 48 months prior to an alleged violation of the Act and/or of the regulation issued thereunder on July 26, 1976? 11/18/93
POLICE OFFICER Kaukauna Police Department City of Kaukauna, WI The Kaukauna Police Department is looking for individuals with a high level of maturity, selfmotivation, and willing to serve the public with a high degree of integrity and ethics. Applications are now being accepted for a full-time position and an eligibility list for future hires. Compensation: Commensurate with experience Competitive benefit package Qualifications: U.S. citizen At least 21 years of age Valid driver s license Good driving record Wisconsin Law Enforcement Standards Board certification Two-year associate degree and/or a minimum of 60 college level credits in related field; bachelors degree preferred Ability to possess a firearm in Wisconsin No felony or domestic abuse convictions Must be in good physical condition Note: Selection process may include any or all of the following: written exam, assessment panel, oral interviews, physical fitness/agility test, psychological profile/exam, background investigation and medical examination including drug screening.