Hamburg Township Police Department MERRILL HAMBURG, MICHIGAN RICHARD DUFFANY, CHIEF OF POLICE PHONE: (810) FAX: (810)

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Hamburg Township Police Department 10409 MERRILL HAMBURG, MICHIGAN 48139 RICHARD DUFFANY, CHIEF OF POLICE PHONE: (810) 231-9391 FAX: (810) 231-9401 Posted: 02/20/14 POSITION: Reserve Police Officer The Hamburg Township Police Department is currently accepting applications from qualified candidates for the position of Reserve Police Officer. RESERVE POLICE OFFICER DESCRIPTION: Reserve police officers serve their community by volunteering their time in order to supplement and support full-time police officers. Police reserves carry the same equipment/weapons as full-time officers and have full police powers when working under the direction of a full-time police officer. In order to maintain their position with the department, reserve police officers must successfully complete all required training and must perform a minimum of 8 hours of service per month. QUALIFICATIONS: Minimum qualifications for the position are: Must be a citizen of the United States Must have reached 21st birthday at time of application Must possess a valid driver's license at time of application Ability to successfully complete all phases of the selection process Ability to successfully pass an extensive background check, physical examination, psychological examination and drug screening test Ability to perform the essential job functions of a police officer Completion of M.C.O.L.E.S approved police academy or reserve police academy preferred Uniforms/Equipment: All required uniforms and equipment, including firearms and bulletresistant vest, will be provided by the Hamburg Township Police Department. APPLICATIONS: Applications and Authorization forms may be obtained on the department website at http://www.hamburq.mi.us/police or in person at the Hamburg Township Police Station located at 10409 Merrill Road, Hamburg, MI 48139. Please submit completed application, resume (optional) and signed authorization form to: Chief of Police Richard Duffany Hamburg Township Police Department 10409 Merrill Road, P.O. Box 157 Hamburg, MI 48139 All application materials must be received no later than 4:00 pm on March 17, 2014.

HAMBURG TOWNSHIP Application for Employment P. O. Box 157 Hamburg, Michigan 48139 (810) 231-1000 Name (Last) (First) (Middle) Social Security Number Address (Street) (City) (State) (Zip) Home Telephone Number ( ) Are you at least 18 years old? Daytime Telephone Number: ( ) Type of position desired: Date available for work: Salary Expected: $ Do you have a valid Michigan Driver s License? License Number: Education High School/College (List last attended first) Address Years Attended/Course Studied Degree Received Military Service From To Additional Skills/Training/Licenses Not Listed Above From To Hamburg Township is committed to EOE in all our personnel practices and prohibits discrimination on grounds of race, color, religion, sex, national origin, age, or physical or mental handicap. Information provided by you on this application form, will be used solely for purposes of assessing your qualifications for potential employment.

Employment History Provide the following information for your current and past employers, assignments or volunteer activities, starting with the most recent. (Use additional sheets if necessary.) Explain any gaps in employment in the comments section below. Describe Your Duties: Describe Your Duties: Describe Your Duties: Describe Your Duties: Comments (Including explanation of any employment gaps):

References Give the names of at least three business/work references, who are not related to you and are not previous supervisors whom we may contact. If not applicable, list three school or personal references who are not related to you. Name Address (Street) (City) (State) (Zip) Occupation Daytime Phone Number Relationship & Years Known Name Address (Street) (City) (State) (Zip) Occupation Daytime Phone Number Relationship & Years Known ( ) Name Address (Street) (City) (State) (Zip) Occupation Daytime Phone Number Relationship & Years Known ( ) Additional Information List professional, trade, business, or civic associations and any offices held. Exclude memberships which would reveal sex, race, religion, national origin, age, color, disability or any other similarly protected status. Organization Offices Held List any additional information you would like us to consider: Have you ever been convicted of a crime? If so, when, where and nature of offense? Convictions will not necessarily disqualify you from employment but will be considered in relation to the position for which you are applying. Are there any felony charges pending against you? If yes, please explain.

I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for denying employment or immediate discharge from the employer s service, whenever it is discovered. I understand it is the Township s policy to adhere to all provisions of the ADA and the Rehabilitation Act of 1973. I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions. Signature of Applicant Date / /

HAMBURG TOWNSHIP P. O. Box 157 Hamburg, Michigan 48139 (810) 231-1000 Authorization and Understanding Upon the signing of the Authorization and Understanding, I represent that all of the information now or hereafter given by me in support of my application for employment is true and complete. I authorize you to verify any of the information concerning my employment, education, training, credentials, driver s license, and criminal history with the appropriate individuals, companies, institutions, or agencies. I authorize them to release such information as you require, including my prior disciplinary employment record. I hereby release you and them from any liability whatsoever as a result of such inquiries and disclosures. I agree that any false information in support of my application may subject me to dismissal at any time during the period of my employment. In the event of an offer of employment, I understand that I may be required to take a drug screen test. In the event of employment, I agree I shall be bound by the rules, policies, and regulations of Hamburg Township, Livingston County, and the State of Michigan. In the event of employment, I authorize Hamburg Township to release such information as a prospective employer may require, including my prior disciplinary employment record. I hereby release you and them from any liability whatsoever as a result of such inquiries and disclosures. Signature Date