Richland County Ohio

A. Minimum Qualifications:

Be a United States Citizen; Be (21) twenty-one years of age or older; Possess an Ohio Peace Officer Certification; Possess a high school diploma or GED; Possess a valid Ohio Driver's License; Pass a Background Investigation; Complete a Truth Verification Examination; Pass a Physical, Drug and Alcohol Examination; and Pass a Psychological Examination.

B. General Information

*Last Name:

*First Name:

*Middle Name:

*Street Address:

*City:

*State:

*Zip:

*Phone Number:

*Social Security Number:

*Email Address:

*Driver's License Number:

*State Issued:

*Date of Birth:

*Are you a citizen of the United States of America:

Yes

*1. Have you ever had any type of protection order filed against you?

Yes

If YES, please list the date(s) of Issue and type:

*2. Have you filed an application with Richland County before:

Yes

If YES, When? Which department/office?

*3. Do you have relatives currently employed at the Richland County Sheriff's Office?

Yes

If YES, please list their name(s):

C. Military Service Information

*Did you ever serve in the United States Military Services?

Yes

*If YES, Branch of Service?

Highest Rank Achieved

Type of Discharge

Reserve or National Guard Status:

Active

Inactive

D. Education Information

*High School Attended:

*City/State:

*Graduated:

Yes

*Dates Attended:

*College Attended:

*City/State:

*Course of Study:

*Degree Earned:

*Dates Attended:

E. Employment History

Account for all times of employment including periods of unemployment within the past 8 years. Begin with present position or occupation. Incomplete information may prevent your application from being processed.

*Company Name:

*Address:

*Phone:

*Dates of Employment:

*Job Title:

*Current Salary:

*Your Duties:

*Reason for Leaving:

*Company Name:

*Address:

*Phone:

*Dates of Employment:

*Job Title:

*Current Salary:

*Your Duties:

*Reason for Leaving:

*Company Name:

*Address:

*Phone:

*Dates of Employment:

*Job Title:

*Current Salary:

*Your Duties:

*Reason for Leaving:

G. Release and Authorization - Please Read Carefully

I certify that all statements contained herein or at any step of the employment process are true, complete, and correct to the best of my knowledge. I understand that a false answer or material omissions may be grounds for dismissal from the Richland County Sheriff’s Office.

By signing this waiver, I expressly authorize the Richland County Sheriff’s Office to complete a thorough investigation of my past employment and activities which may include, but not be limited to, an operator license record check, criminal history check, and financial credit check, etc. I also authorize the Richland County Sheriff’s Office to complete an inquiry of my former employer(s) concerning my work record, job qualifications and performance. I authorize my former employer to furnish the Richland County Sheriff’s Office with this information upon their request. I recognize the right of the Richland County Sheriff’s Office to treat, at its discretion, certain sources as confidential, and its right to withhold from me or my agent the names of such confidential sources, and information obtained there from.

*Signature

Signature

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