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1 Application Packet Cover letter Position: Patrol Deputy Interviews begin immediately and will continue until all positions are filled Patrol Deputies are scheduled on rotating 12-hour shifts. Starting wages $20.19 per hour; additional compensation available based on experience and training. Hiring preference given to applicants with a current rth Dakota Peace Officers License or equivalent. Williams County provides a generous benefit package to full-time regular employees including paid sick and vacation leave, a fully paid health/dental/vision benefit plan, term life insurance of $25,000, full payment of law enforcement retirement benefits through the ND Public Employees Retirement System (15.45% paid by Williams County), and 11 holidays each year. All offers of employment will be contingent successful completion of a preemployment background check, drug screening, driving record check and reference review. Human Resources Helen Askim, Human Resources Administrator PO Box E. Broadway Williston, ND Phone Fax Helena@co.williams.nd.us
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3 APPLICATION SCREENING AND RATING FORM Applicant Name Date Completed Mark the following areas where you have experience, training, advanced knowledge, or licensure: Work Experience o Security Industry o Law Enforcement o Corrections (jail, prison, etc) o Military o Juvenile Detention/Probation o Mental Health Professions o Experience writing narrative reports o Experience operating an emergency response vehicle Equipment and Physical Demands o Ability to lift or drag 160 pounds o Ability to sit and stand for extended periods of time o Experience answering calls on a multiline business telephone system o Experience using a multi-band radio o Proficiency operating a firearm o Experience operating a computer Degrees, licensing or specialized training o High school diploma or GED o Licensed Peace Officer o o Other: rth Dakota P.O.S.T. o Licensed Corrections Officer o rth Dakota P.O.S.T Other: o o Ability to acquire/maintain Peace Officer licensing o Medical Training (i.e. EMT, CNA) o Training in defensive tactics o Ability to travel out-of-town for training o Valid ND Drivers License or equivalent o Resident of Williams County or ability to become a resident of Williams County o Other Have you obtained housing in Williston area? Maybe (explain: ) Which of the following are you able and willing to work: o Shift work 6am-6pm or 6pm-6am o ends and holidays o Overtime shifts o During in climate weather o With individuals who are violent, confrontational and/or manipulative Williams County Application Attachment Patrol Deputy January 2013
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5 APPLICATION FOR EMPLOYMENT (June 2012) Check for errors & signatures before submitting Print or type If accommodation or assistance is needed in completing this application please contact Williams County Human Resources at Position applying for: General Information Name (Last, First, Middle Initial) Mailing City State Zip Code Local (if different than above) City State Zip Code Work Telephone Home Telephone Cellular/Other Telephone Primary telephone number for calls related to this job opening Work Home Cellular/Other Can you provide proof, if hired, that you are eligible to work in the United States? Have you ever been convicted of a crime other than a minor traffic violation? If yes, please explain (Convictions are not an absolute bar to employment but will be considered in relationship to the job requirements.) How did you learn about this opening? Veteran's Preference Veteran Eligibility: You must be a ND resident and have served in the active military forces during a period of war or received the armed forces expeditionary or other campaign service medal during an emergency condition, and must have been released under other than dishonorable conditions. See NDCC Do you claim preference as a: Veteran? - Must attach DD-214, Report of Separation) Disabled Veteran? - Must attach DD-214 & letter less than 1 yr. old from V.A. indicating disability Spouse of a Disabled Veteran? - Must attach DD-214 & letter less than 1 yr. old from V.A. indicating disability Spouse of Deceased Veteran? - Must attach DD-214 & letter less than 1 yr. old from V.A. indicating disability Education and/or Training Did you graduate from high school or receive a GED Certificate?. of Credits Field Did you graduate? SCHOOL NAME AND LOCATION Qtr. Sem. Major Minor (college, business, nursing, vocational, or other) Related volunteer experience or education/training Diploma or degree earned License or Certification (include drivers license information) License/Certification State Profession License/Certification # Expiration Date
6 Employment History: (Provide detail; do not use see resume. ) Start with your current or last job include military service and self-employment. Any change of position with the same employer should be considered a separate position. Complete pages 3 and 4 if you have additional employment history. May we contact your current employer for a reference? t Applicable Go on to page 3 if you have additional employment history. I certify that all information contained in this application and any attachments is true and complete to the best of my knowledge. I understand that any willful misrepresentation, false statement, or omission by me in the application or interview process will be cause for rejection of my application or termination of my employment. I authorize investigation of all statements made on this application and any attachments, and I release all persons, companies, and organizations from liability for providing or receiving such information. I further understand that this employment application and other employment related documents are not contracts of employment; and, that any oral or written statements to the contrary are hereby expressly disavowed. Applicant's Signature Date All information provided is subject to the rth Dakota Open Records Law Equal Opportunity Employer Williams County does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services and complies with the provisions of the rth Dakota Human Rights Act. Williams County Job Application - Page 2
7 Name: Additional Employment History: Williams County Job Application - Page 3
8 Name: Additional Employment History: Williams County Job Application - Page 4
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