Personal DataName First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Driver's License Number Home PhoneMobile PhoneWork PhoneEmail* Scars, Marks or TattoosBlood Type Are you a citizen of the United States?YesNoTraffic violations in the last five yearsConvictions, other than trafficEmploymentCurrent Employer Name Current Employer Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code List all employer names and addresses for the past 10 yearsEducationHigh School name and location High School major studies College name and location Degree(s) received Other schools or training Additional InformationForeign Languages (read, write, or speak)Hobbies or special interestsField of military service Years / Months of military service Red Cross Training (include dates) Prior Police Training (include dates)Past / Present memberships in other organizationsReferencesCharacter references (other than family)Additional InformationHave you previously applied for auxiliary police work? If yes, please explainWho referred you to this organization? Why do you want to join the Euclid Police Auxiliary?Do you feel that you can devote significant time to this organization?YesNoWhen are you available for training? Use this space to provide additional information, including any resume you may wish to provide.Applicant's StatementPlease read and agree to the statement below by cheking the box before submitting this application.* I certify that the information contained in this application is true and complete to the best of my knowledge. I understand that false statements or omissions on this application are grounds for immediate disqualification or dismissal upon discovery thereof. I authorize the references listed to give you any and all information concerning my previous employment and any pertinent information they have, personal or otherwise, and release all parties from liabilities for any damage that may result from furnishing the same to you. Applicants Please NoteA full background check will be conducted by the Euclid Police Department. A valid State of Ohio driver's license is required. Today's Date MM slash DD slash YYYY CommentsThis field is for validation purposes and should be left unchanged.