BCSO Employment Application

Barrow County Sheriff's Office | 233 E Broad St., Winder, GA 30680 | (770) 307-3080

Application for Employment | Barrow County is an Equal Opportunity Employer | Drug Free Work Place

Last Name(Required)

First Name(Required)

Middle Initial

Barrow County Sheriff's Office Application for Employment

It is the policy of the Barrow County Sheriff’s Office that all applicants meet the minimum qualifications of the position applied for. It is your responsibility to review the minimum qualifications contained within the appropriate applicable job description prior to continuing with the completion of the Application for Employment packet.

The Barrow County Sheriff’s Office has established high standards for its employees. It is the policy of this agency to hire only the best qualified individuals for full and part time positions. Our employee selection process is thorough and regimented. It affords the opportunity to everyone regardless of race, creed, color, gender, religion, national origin, age, sexual orientation, disability, or any other legally protected classification. All eligible applicants will be afforded the same opportunity for employment selection. Accordingly, should you have a disability or disabling condition, you may request any reasonable accommodation in order to further participate in the application process by contacting the Barrow County Sheriff’s Office Employee Services Office at 770-307-3080 ext. 3133.

The complete Application for Employment packet contains the following documents:

1. Instruction Sheet (1 page)

2. Factors for Disqualification (1 page)

3. Waiver and Authorization for Release of Information. (1 page)

4. Personal History Questionnaire (5 pages)

5. Background Investigation Questionnaire (12 pages)

All questions contained in the Application for Employment MUST be answered fully and completely. If a question does not apply to you, indicate so by placing “N/A” in the field. If your answer to the question is “No,” indicate so by writing “No” in the field. Failure to complete this application accurately and fully may subject your application to disqualification.

Application Instructions

Please Read Carefully

1. Please Check the position(s) for which you are applying:

Position Choice:(Required)

Deputy Sheriff

Detention Officer

Secretarial/Clerical

Records

Other

Which Other Position?

2. Please Make sure that ALL questions in this application are answered completely. If a question does not apply to you, indicate so by placing “N/A” in the field. If your answer to a question is “No” indicate so by writing “No” in the field. An incomplete application will not be considered.

3. This application is in two (2) parts. The first part is a General Application for Employment which contains the Instruction Page, Factors for Disqualification, and the Waiver for Release of Information. The second part is a Personal History Questionnaire.

4. You may be asked to provide the following certified copied documents in-person: NO ORIGINALS, PLEASE

a. High School Diploma or GED certificate

b. Birth Certificate

c. DD-214 (if veteran)

d. Georgia Driver’s License

5. To be eligible for consideration for employment, you must submit to the following:

a. Oral Interview

b. Fingerprint and Background Investigation

c. Credit Investigation

d. Drug Screening

e. Physical Examination

f. Polygraph Examination

g. Psychological Examination

6. When you have completed this Application for Employment, if you are asked to present copies of any documents, you are required to bring them to the Employee Services Officer whose office is located at the Barrow County Sheriff’s Office, 233 E Broad Street, Winder, GA 30680. If you have any questions please call 770-307-3080 ext. 3133.

Factors for Disqualification

Read carefully AND complete the form where indicated (signatures will be done in-person prior to an interview).

An applicant may be disqualified and cannot be considered for employment if ANY of the following situations exist:

1. Conviction in any court for a felony offense.

2. Conviction in any court for a drug related offense.

3. Any pending criminal actions in any court.

4. Presently under investigation for any criminal offense by this or any other law enforcement agency.

5. Dishonorable discharge from any branch of the military.

6. Unable, for any reason, to obtain a Georgia Driver’s License.

7. Absence of high school diploma or GED certificate.

8. Tattoos on the head, face (including the inside of the mouth), neck, or hands.

9. Any known association with any group, organization, or otherwise whose primary objective is to foster hatred, oppression, or persecution of any individual, group of individuals, or any private or public company or organization.

10. Not having attained the age of 18 years for Detention Officer or 21 years of age for Deputy Sheriff at the time of application.

11. In accordance with the Immigration Reform and Control Act of 1986, proof of authorization to be employed in the United States will be required of all prospective employees. Failure to establish such proof will prohibit or discontinue employment.

I,(Required)

certify that I have read the entire contents of this page and fully understand the same. I also certify, that to the best of my knowledge, none of the situations stated above apply to me.

Waiver and Authorization for Release of Information

Read carefully AND complete the form where indicated (signatures will be done in-person prior to an interview).

I hereby authorize a review of and full disclosure of all records concerning me,

Full Name 2(Required)

(Required)

, to any duly authorized agent of the Barrow County Sheriff’s Office whether said records are of a public, private or confidential nature. The intent of this authorization is to give my full consent for full and complete disclosure of all records including, but not limited to, records of educational institutions, GCIC and/or NCIC criminal history records, financial or credit institutions including reports or ratings and other financial statements and records, including background reports, efficiency ratings, complaints or grievances filed by or against me, and the record and reconciliations of attorneys or other counsel whether representing me or another party in any case either criminal or civil in which I presently have or have had an interest.

I understand any information obtained in a personal history background investigation arising in whole or in part, directly or indirectly, from this waiver and authorization will be considered in determining my suitably for employment with the Barrow County Sheriff’s Office.

I certify any person furnishing information concerning me shall not be held accountable for such information, and I hereby release said person from any and all liability, be it civil or criminal in nature, which may be incurred as a result of furnishing such information. I understand that the 1974 Privacy Act affords me the right to expect certain types of information not to be disseminated by persons who have access to such information. For the purpose of a personal history background investigation to determine my suitability for employment with the Barrow County Sheriff’s Office, I hereby WAIVE said rights.

Please Enter Your Full Name Again for Confirmation of the Agreement(Required)

Section I – Identification Information

Last Name(Required)

First Name(Required)

Middle/Maiden Name

Date of Birth(Required)

Social Security Number(Required)

Sex(Required)

Height

Weight

Race

Place of Birth: County, City, State

Are you a U.S. Citizen?(Required)

Yes

No

Section II – Current Address Information

Current Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Mailing Address if Different

Street Address Address Line 2 City State ZIP Code

Years at current home address

Primary Phone Number

Secondary Phone Number

Alternate Phone Number

Section III – Driver's License Information

Do you have a current GA drivers' license?(Required)

Yes

No

GA License Number if YES:

Do you have a current license from another state?

Yes

No

Other State License Number if YES:

State of Other License:

State

Section IV – World Wide Web Information

Do you have a web page?

Yes

No

If YES, what is your web page?

http:// or https:// is required

How many email addresses do you have?

Please list any email addresses you may have.

Primary Email Address(Required)

Second Email Address

Third Email Address

Fourth Email Address

Fifth Email Address

Sixth Email Address

List the name of any internet social networking sites you are currently or have ever been a member of. Include the name used for each site.

First Social Networking Site

Second Social Networking Site

Third Social Networking Site

Fourth Social Networking Site

Fifth Social Networking Site

Sixth Social Networking Site

Section V – Employment History

1.

1. Employer Name(Required)

1. Employer Phone Number(Required)

1. Employment Dates(Required)

1. Employer Address(Required)

1. Employer City and State(Required)

1. Your Position(Required)

1. Salary

1. Supervisor's Name(Required)

1. Duties Performed(Required)

1. Reason for Leaving(Required)

2.

2. Employer Name(Required)

2. Employer Phone Number(Required)

2. Employment Dates(Required)

2. Employer Address(Required)

2. Employer City and State(Required)

2. Your Position(Required)

2. Your Salary

2. Supervisor's Name(Required)

2. Duties Performed(Required)

2. Reason for Leaving(Required)

3.

3. Employer Name(Required)

3. Employer Phone Number(Required)

3. Employment Dates(Required)

3. Employer Address(Required)

3. Employer City and State(Required)

3. Your Position(Required)

3. Salary

3. Supervisor's Name(Required)

3. Duties Performed(Required)

3. Reason for Leaving(Required)

Section continues on next page

Section V – Continued

4.

4. Employer Name(Required)

4. Employer Phone Number(Required)

4. Employment Dates(Required)

4. Employer Address(Required)

4. Employer City and State(Required)

4. Your Position(Required)

4. Salary

4. Supervisor's Name(Required)

4. Duties Performed(Required)

4. Reason for Leaving(Required)

5.

5. Employer Name(Required)

5. Employer Phone Number(Required)

5. Employment Dates(Required)

5. Employer Address(Required)

5. Employer City and State(Required)

5. Your Position(Required)

5. Salary

5. Supervisor's Name(Required)

5. Duties Performed(Required)

5. Reason for Leaving(Required)

6.

6. Employer Name(Required)

6. Employer Phone Number(Required)

6. Employment Dates(Required)

6. Employer Address(Required)

6. Employer City and State(Required)

6. Your Position(Required)

6. Salary

6. Supervisor's Name(Required)

6. Duties Performed(Required)

6. Reason for Leaving(Required)

End of Section V

Section VII Continued

Have you received any traffic citations in the past five (5) years?(Required)

Have you ever been convicted of OR plead guilty OR no contest to a misdemeanor?(Required)

Have you ever been convicted of OR pled guilty OR no contest to a felony?(Required)

Have you ever been suspended dismissed or asked to resign from any job?(Required)

Section VIII – Other Training/Skills/Languages

Please List Any Other Training/Skills/Languages:

Section IX – Signature

Read carefully AND complete the form where indicated (signatures will be done in-person prior to an interview).

Attestation:

I hereby certify that each and every statement that I have made in this application is true and complete to the best of my knowledge and belief. I understand that any untrue statement in this application will result in my dismissal at any time during my employment with the Barrow County Sheriff’s Office.

I further understand that any intentional false statement made in this application will result in my disqualification of my application and/or prosecution for the offense of False Swearing (O.C.G.A. 16‐10‐71), which is punishable by a maximum fine of $1,000 plus imprisonment for not less than one nor more than five years or both.

I further understand that any erroneous answers given by me in this application and/or during any part of the application process, whether intentional or not, will constitute a basis for my elimination from consideration for the employment I now seek. I understand that if I do not wish to answer a question in the process, I may choose to do so and my application may be terminated.

I understand that I may be required to produce documentation verifying identity and employment eligibility in the United States. I understand that I may be required to verify any and all information provided in this application. I understand that this completed application, and copies of any documentation provided in support of this application shall be and become the property of Barrow County Sheriff’s Office and will not be returned.

The Sheriff’s Office is hereby authorized to make any investigation of my personal, educational, criminal, financial, credit, driving, past employment, reputational, military service and other personal history and actions to assist in determining my qualification and fitness for the position I am seeking with this agency.

I understand that I must notify the Employee Services Office of any changes in my name, address, or phone number. I further understand that certain information I have provided on this application may be subject to public disclosure under the Georgia Open Record Act.

Section IX – FULL NAME(Required)

By entering your Full Name, you signify that you understand and agree to the Attestation above.

Section IX – TODAY'S DATE(Required)

Barrow County Sheriff's Office Application For Employment

233 E Broad Street, Winder, GA 30680

The Barrow County Government and the Barrow County Sheriff’s Office are equal opportunity employers. Applicants for all positions within the Barrow County Government and the Barrow County Sheriff’s Office are considered for employment based upon their qualifications for the position applied for and without regard to race, creed, color, gender, religion, national origin, age , sexual orientation, disability, or any other legally protected status.

The Barrow County Sheriff’s Office maintains strict hiring guidelines that ALL applicants must satisfactorily meet or surpass in order to be considered for any position within the Sheriff’s Office.

The following questions address several of the areas covered in the hiring guidelines. Your responses will be verified during the background investigation process. Complete and honest answers are required. Any negative facts contained within the information provided in this questionnaire will be evaluated to determine compliance with those guidelines. Any false or misleading information uncovered during investigation of your background may result in the immediate disqualification of Application for Employment. Therefore, it is imperative that ALL your answers to the questions are truthful and honest to the best of your ability.