Form Center

Step One

Position Desired*
Date of Application*
Date of Application
Email address*
First Name*
Middle Name
Last Name*
Phone Number*
Birth Date*
Birth Date
Have you ever changed your name? *
1. Yes
2. No
If yes, when?
If yes, when?
List all other names:
Street Number*
Please provide your current residence.
Street Name*
Apt #
City*
State*
Zip*
How long at this address?*
How long a resident of York County?
How long a resident of South Carolina?
Best Time to Call*
Are you willing to relocate?
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Step Two

Step Three

Have you applied with the City of Tega Cay Police Department before?*
If yes, when?
If yes, when?
Are you a former employee?*
Are you eligible to work in this Country? (proof of citizenship or work visa will be required)*
Are you available for overtime if required?*
Will you submit to a pre-employment physical?*
Can you work shift type work? *
Are you able to work nights, weekends, and/or holidays?*
Have you applied at any other Law Enforcement agency within the last 5 years?*
If yes, list the agency name and the application date.
Have you ever been convicted of a criminal offense, including traffic offenses?*
Such conviction may be relevant, but does not necessarily bar you from employment.
If yes, please describe:
Include date, place, charge, and final disposition.
Drivers License Number*
State Issued*
Has your driver's license ever been suspended?*
If yes, when?
If yes, when?
Reason:
Have you had any credit problems in the past five years? *
If yes, please explain:
List anyone you know who works for the Tega Cay Police Department:
Do you have any relatives who are employed by the Tega Cay Police Department? If yes, who?*
Has any member of your immediate family ever been convicted of a felony?*
If yes, please include date, place, charge, and final disposition.
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Step Four

Current or Previous Employer*
Dates of Employment*
Dates of Employment Start Date
—
Dates of Employment End Date
Address
City and State
Position(s) worked*
Reason for Leaving*
May we contact them?*
Phone Number*
Previous Employer
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Address
City and State
Position(s) worked
Reason for Leaving
May we contact them?
Phone Number
Previous Employer
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Address
City and State
Position(s) worked
Reason for Leaving
May we contact them?
Phone Number
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Step Five

List any special abilities, interests, or hobbies:
List professional, volunteer, trade, business, or civic activities and office held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status.
Have you ever belonged to any group that promotes, urges, or seeks to overthrow the government of the US or State of South Carolina? *
If yes, explain.
Training and Certifications
List any training or certifications you may have that may better qualify you for the position you are seeking.
Education*
List what education levels you have achieved, name of the institution, degree achieved, and year completed (ex. 2003).
References
References
Give three references who are responsible adults of reputable standing.
First Name*
Last Name*
Address1*
City*
State*
Zip*
Occupation*
Phone*
Years Acquainted *
First Name*
Last Name*
Address1*
City*
State*
Zip*
Occupation*
Phone*
Years Acquainted *
First Name*
Last Name*
Address1*
City*
State*
Zip*
Occupation*
Phone*
Years Acquainted *
Have you ever served on active duty in the Armed Forces of the United States? *
Branch of Service
Serial Number
Type and Basis for Discharge from Armed Forces
Please list the information of your discharge from the Armed Forces (type and basis).
Are you now a member of any reserve unit?
1. Yes
2. No
3. Ready
4. Stand by
Dates in Service
Dates in Service Start Date
—
Dates in Service End Date
If you are in a pay status requiring that you attend drills, meetings, or camps, give name of unit and location:
If you were ever exempt from service in the Armed Forces, state reason:
If you are disabled, and wish to be identified as such, according to the Rehabilitation Act of 1973, please indicate so by checking the box below.
1. Yes
Other Information
Please list any other information that you think is pertinent to the position applied for.
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It is understood and agreed that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed. Furthermore, I understand that just as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary. I give the Employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the Employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. The Employer is an equal opportunity employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excluding any applicant's consideration for employment on a basis prohibited by local, state or federal law. This application is current for only sixty (60) days. At the conclusion of this time, if I have not heard from the Employer and still wish to be considered for employment, it will necessary for me to fill out a new application.
By checking the box below, I certify that all the information provided above is true and accurate to the best of my knowledge.*
1. Yes

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