SWANSEA POLICE DEPARTMENT RESERVE POLICE OFFICER TEST

Transcription

1 George Arruda Chief of Police Town of Swansea, Massachusetts Police Department 1700 GAR Highway Swansea, Massachusetts Telephone (508) Fax (508) SWANSEA POLICE DEPARTMENT RESERVE POLICE OFFICER TEST Your completed application MUST be returned to the Swansea Police Station. A check or money order in the amount of $30.00, made payable to the Swansea Police Department must accompany the application at that time. Should the applicant not show up for the written test, the application fee will not be returned. The physician's release portion of the application will be required prior to the agility test. You must provide the physician's release and undergo a physical examination (at your own expense) prior to your being allowed to participate in a physical fitness examination. Successful candidates who have passed the written and physical testing will require psychological testing (at their own expense). 1) Agility Test Location: Joseph Case Sr. High School (Track) 70 School Street Swansea, MA ) Written Test Location: Swansea Police Department 1700 G.A.R. Highway Swansea, MA At the time of testing, you must provide positive photo identification (driver's license or passport).

2 George Arruda Chief of Police Town of Swansea, Massachusetts Police Department 1700 GAR Highway Swansea, Massachusetts Telephone (508) Fax (508) APPLICANT INFORMATION DUTIES AND RESPONSIBILITIES: 1. The Reserve Officers may be assigned to work on scheduled Patrol shifts and to perform dispatching duties. 2. Reserve Officers may also work assignments as authorized by the Chief of Police including working on special occasions such as parades, Halloween, and the Fourth of July. 3. After field training and a break-in period, the Reserve Officer may be allowed to work police details. 4. Reserve Officers will be evaluated by patrol officers and supervisors on a regular basis, and appointed annually. 5. Reserve Officers who have completed all training requirements and regularly participate in work assignments, will be eligible to fill full-time police patrolman vacancies. APPLICATION REQUIREMENTS: 1. Minimum 60 college credits and/or 2 years active military service and/or 4 years of National Guard Reserve Service. 2. Must possess a valid driver's license. 3. MPTC Basic training course of Reserve/Intermittent Police Officers. 4. Must be eligible to obtain a Class A license to carry a firearm and possess a valid driver s license. DOCUMENTS: 1. Copy of birth certificate and citizenship papers (if you are a naturalized U.S. citizen). 2. Copy of your College Degree, High School, GED Certificate or proof of military service. 3. A copy of your valid driver's license. 4. A physician release, no more than six (6) months old. 5. Passport size photo attached to application.

3 APPLICANT INFORMATION (cont.) SELECTION PROCESS: 1. Written Examination 2. Physical Agility Test- Position of Police Officer 3. Interview by impartial panel of Police Officers 4. Background check 5. Selection by the Board of Selectmen APPLICATIONS MUST BE SUBMITTED IN A SEALED ENVELOPE THE SWANSEA POLICE DEPARTMENT IS AN EQUAL OPPORTUNITY EMPLOYER

4 THIS APPLICATION MUST BE FILLED OUT COMPLETELY, OTHERWISE YOU WILL BE INELIGIBLE TO TAKE THE EXAMINATION. RESERVE HIRING PROCESS FOR THE SWANSEA POLICE DEPARTMENT IS AS FOLLOWS: 1. Successfully pass the exam. 2. Successfully pass the physical agility test. 3. Successfully pass the interview and background checks. 4. Successfully pass a psychological examination. 5. Successfully complete dispatch training. UPON COMPLETION OF THE ABOVE: 6. Successfully complete Field Training Program. PLEASE NOTE: All training and psychological test fee is at the Recruit's own expense. THE SWANSEA POLICE DEPARTMENT HIRES FULL-TIME POLICE OFFICERS EXCLUSIVELY FROM ITS RESERVE RANKS.

5 George Arruda Chief of Police Town of Swansea, Massachusetts Police Department 1700 GAR Highway Swansea, Massachusetts Telephone (508) Fax (508) APPLICATION FOR EMPLOYMENT DATE: Application must be clearly printed in ink in applicant's own handwriting. If applicable, all questions must be answered. Applications that are incomplete and/or illegible will not be considered. PERSONAL HISTORY NAME IN FULL (Last, First, Middle) LIST ALL OTHER NAMES/NICKNAMES IF YOU HAVE EVER CHANGED YOUR NAME, GIVE DATE, PLACE AND REASON PRESENT HOME ADDRESS, ADDRESS AND ZIP CODE DATE OF BIRTH (MO./DAY/YEAR) PLACE OF BIRTH (CITY, STATE) MALE FEMALE ARE YOU A RESIDENT OF MASSACHUSETTS? YES NO ARE YOU A CITIZEN OF THE U.S.? IF NOT, WHAT STATE? IF NATURALIZED, PLACE OF NATURALIZATION & NUMBER RESIDENCE TELEPHONE BUSINESS TELEPHONE SOCIAL SECURITY NUMBER LIST ALL ADDRESSES YOU HAVE USED WITHIN THE PAST 3 YEARS: WEIGHT: HEIGHT: DO YOU HAVE ANY MARKS OR SCARS (TATTOOS, ETC.)? YES NO IF YES, DESCRIBE: DO YOU WEAR GLASSES OR CORRECTIVE LENSES? YES NO IF YES, CORRECTABLE TO 20/20? YES NO HAVE YOU EVER SUBMITTED AN APPLICATION FOR EMPLOYMENT WITH THE SWANSEA POLICE DEPARTMENT OR ANY OTHER LAW ENFORCEMENT AGENCY? YES NO IF YES, DATE DEPARTMENT NAME: THE SWANSEA POLICE DEPARTMENT IS AN EQUAL OPPORTUNITY EMPLOYER

6 PERSONAL QUESTIONNAIRE List any special skills or training that you have acquired that would be beneficial to the Swansea Police Department. (Include language skills, firearms training, scuba diving, etc.) List any awards, certificate or honors received other than those listed under the "educational" section of this application. List hobbies and recreational interests: List any public service or community activities that you are or have been involved in: Explain in your own words why you are interested in becoming a Police Officer and a member of the Swansea Police. Department: Is there anything in your background or personal history that would adversely affect your ability to perform the duties and responsibilities of a Swansea Police Officer:

7 EMPLOYMENT (CONT.) NAME AND ADDRESS OF DATES SALARY POSITION &,TYPE SUPERVISOR REASON EMPLOYER TYPE OF WORK (Include Phone FOR (Include Telephone Number) Number) LEAVING Name FROM TO MO DY YR MO DY. YR Address City & State Name Address City & State Name Address City & State Name Address City & State MILITARY RECORD Have you ever served on active duty in.the Armed Services of The U.S.? NO YES Branch of Military service (Active Duty) Duty Position (MOS) Highest rank attained: Date Commissioned (if applicable): Serial Number Dates of Active Duty (Mo/Day/Year) Type of Discharge received? Basis for Discharge From To Are you now, or were you ever in the Reserves or National Guards? If yes, give the name of the Unit attached, address, phone number and location. (If former member, give last Unit attached). YES NO While a member of any Armed Services, Reserves or National Guards of the U.S., was any type of disciplinary action taken Against you? If yes, give the nature of the action, what branch of Service and dates. YES NO List any specialized training you may have received while in the military service, National Guard, or Reserves (include dates of training). TYPE OF TRAINING DATE

8 EDUCATION DATES FROM TO M D Y M D Y MAJOR DEGREE OR NAME OF SCHOOL 0 A R 0 A R COURSE OF DIPLOMAS INCLUDE PHONE# LOCATION y y OF STUDY OBTAINED HIGH SCHOOLS (OR GED) Address: Name: Phone#: Name: COLLEGES Address: Phone#: Address Name: Phone #: Name: GRADUATE SCHOOL Name: Name: Address: Phone#:.Address: Phone#: Address: Phone#: MISCELLANEOUS COURSES Name: Address Phone#: Name: Address: Phone#: Were you ever dismissed from a school, or was any disciplinary action taken against you during your scholastic career? No Yes - - SCHOOL DATE TYPE OF ACTION List awards, honors, citations, positions held in school organizations, athletic endeavors, and any other special recognition you received while attending school

9 FORMER ADDRESSES List chronologically if away from all of your residences in the past ten (10) years (include addressed while attending school, away from home and all military addresses including any off base addresses). DATES FROM TO M D Y M 0 Y STREET ADDRESS 0 A R (j A R (include telephone numbers y y APT.# of former landlords) CITY STATE ZIP CODE EMPLOYMENT List chronologically ALL employment, including summer and part-time employment while attending school. All time must be accounted for. If employed for a period, indicate, setting forth dates of unemployment. NAME & ADDRESS SUPERVISOR OF EMPLOYER DATES POSITION & (Include REASON (Include FROM TO TYPE OF Phone FOR telephone number) MO DY YR MO DY YR SALARY OF WORK Number) LEAVING Name Address Cit & State Name Address Cit & State Name Address Cit & State Name Address City & State

10 REFERENCES Give three (3) references (not relatives, former or present employers, fellow employees or school teachers) who are responsible adults of reputable standing in the communities, such as property owners, business or professional men or women including your physician. If you have one who has known you well, preferable those who have known you during the past five (5) years. If retired, give former occupation. Complete Name: Addresses: Residence Number Years Acquainted: Occupation: Business: Teleph.one #: Complete Name: Addresses: Residence Number Years Acquainted: Occupation: Business: Telephone #: Complete Name: Addresses: Residence Number Years Acquainted: Occupation: Business: Telephone #: CREDIT RECORD Are you indebted to anyone? Yes No (List any debt over $1,000. Also list any debt regardless of the amount where payment is past due.) CREDITOR ADDRESS AMOUNT. LOAN ACCT. NUMBER COURT RECORD 1. Have you ever been arrested? Yes No 2. Have you ever been charged with a criminal offense: Yes No 3. Have you ever plead guilty, nolo contenders or been convicted of any misdemeanor or felony offense (regardless) Yes No 4. Have you ever been issued a motor vehicle citation? Yes No If you answered yes to any of the above, list charges, dispositions and jurisdiction where the incident occurred below:

11 ORGANIZATION MEMBERSHIP Are you now, or have you ever been a member of any club, group or organization? YES NO- If"YES", list below: NAME CITY & STATE FORMER PRESENT (List position held & extent of activity? Do you possess a valid driver's license? License#: YES DRIVING HISTORY NO State: Have you ever held a driver's license in any other State other than the State listed above? YES NO License# State Date License# State Date License# State Date Has your license in this-state or any other State ever been revoked or suspended? If your answer is yes, give details, include dates) YES NO Have you ever been involved in a motor vehicle accident? YES NO If your answer is yes, give details below: DATE CITY, STATE DETAILS Types of other licenses you hold: (Motorcycles, trucks, boats, etc., include license#, where obtained and expiration date if applicable.

12 What physicians have treated you in the last five (5) years? MEDICAL HISTORY What was the nature of your illnesses? If you have any injuries, please note them below: Who treated you? ; When? ---- Where? If you have any deformities, please note them below:, If you have had any surgeries, please note them below: If yes, who was the Surgeon? When? Where? Have you consulted a Physician during the past year? Do you have any chronic illnesses that you know about?

13 RELATIVES All applicants must give complete information concerning their relatives. If you have been married more than once, give the requested information concerning each former husband or wife, even though a relative is deceased, give all the information requested, and indicate last residence and year of death. Include stepbrothers and sisters, half brothers and sisters. If you are engaged to be married or contemplating marriage in the near future, complete information regarding your future husband or wife and clearly show that such relationship is a future one. MARITAL STATUS: Single Married Separated Divorced Widowed IF MARRIED, PLACE OF MARRIAGE: DATE OF MARRIAGE: NUMBER OF CHILDREN: ) PLACE OF DIVORCE OR LEGAL SEPARATION (IF APPLICABLE) COURT DATE FINAL DISPOSITION COMPLETE NAME, INCLUDING MIDDLE NAME (NO INITIALS) AND COMPLElEADDRESS AND PHONE NUMBERS OCCUPATION (NAME, ADDRESS & PHONE NUMBER WHERE EMPLOYED FATHER'S NAME: -: PLACE OF BIRTH: MOTHER'S NAME: PLACE OF BIRTH: WIFE OR HUSBAND (If wife, include maiden name):

14 RELATIVES (Continued)' COMPLETE NAME, INCLUDING MIDDLE NAME (NO INITIALS) OCCUPATION (NAME, ADDRESS & PHONE AND COMPLETE ADDRESS AND PHONE NUMBERS NUMBER WHERE EMPLOYED CHILDREN: CHILDREN:. ; - " --'-----' '("., 't ' CHILDREN:. ' NATURALIZATION ORALIEN REGISTRATION NUMBER, DATE, PHONE NUMBER AND PLACE OF NATUR!\LIZATIOt:J.Of Applicable): CHILDREN:.

15 RELATIVES (Continued) COMPLETE NAME, INCLUDING MIDDLE NAME (NO INITIALS) OCCUPATION (NAME, ADDRESS & PHONE AND COMPLETE ADDRESS AND PHONE NUMBERS NUMBER WHERE EMPLOYED SISTER: SISTER: ;. SISTER: SISTER:

16 RELATIVES (Continued) COMPLETE NAME, INCLUDING MIDDLE NAME (NO INITIALS) OCCUPATION (NAME, ADDRESS & PHONE AND COMPLETE ADDRESS AND PHONE NUMBERS. NUMBER WHERE EMPLOYED BROTHER: -.,- BROTHER:.;. BROTHER: PHONE NUMBER AND PLACE OF NATURALIZATION (If Applicabl ): BROTHER:

17 WHAT IS PHYSICAL FITNESS? Physical fitness is a health status pertaining to the individual officer having the psychological readiness to perform maximum physical effort when required. Physical fitness consists of four areas: Aerobic capacity or cardiovascular endurance pertaining to the heart and vascular system's capacity to transport oxygen. It is also a key area for heart disease in that low aerobic capacity is a risk factor. Strength pertains to the ability of muscles to generate force. Upper body strength and abdominal strength are important areas in that low strength levels have a bearing on upper torso and lower back disorders. Flexibility pertains to the range of motion of the joints and muscles. Lack of lower back flexibility is a major risk for lower back disorders. WHY IS FITNESS IMPORTANT AS A JOB RELATED ELEMENT FOR LAW ENFORCEMENT OFFICERS? It has been well documented that law enforcement personnel (as an occupational class) have serious health risk problems in terms of cardiovascular disease, lower back disorders and obesity. Law enforcement agencies have the responsibility of minimizing known risk. Physical fitness is a health domain which can minimize the "known" health risk for law enforcement officers. Physical fitness has been demonstrated to be a bona fide occupational qualification. Job analyses that account for physical fitness have demonstrated that the fitness areas are underlying factors determining the physiological readiness to perform a variety of critical physical tasks. These four fitness areas have also been shown to be predictive of job performance ratings, sick time and number of commendations of police officers. Data also shows that fitness level is predictive of trainability and academy performance. Physical fitness can be an important area for minimizing liability. The unfit officer is less able to respond fully to strenuous physical activity. Consequently, the risk of not performing physical duties is increased.

18 HOW WILL PHYSICAL FITNESS BE MEASURED? The physical fitness battery consists of 4 basic tests. Each test" is a scientific valid test. The tests to be given are described as follows: 1. Sit and Reach Test This is a measure of the flexibility of the lower back and upper leg area. It is an important area for performing police tasks involving range of motion and is important for minimizing lower back problems. The test involves stretching out to touch the toes or beyond with extended arms from the sitting position. The score is in the inches reached on a yard stick with 15 inches being at the toes Minute Sit-Up Test This is a measure of the muscular endurance of the abdominal muscles. It is an important area for performing police tasks that may involve the use of force and is an important area for maintaining good posture and minimizing lower back problems. The score is in the number of bent leg sit-ups performed in 1 minute Repetition Maximum Bench Press This is a maximum weight pushed from the bench press position and measures the amount of force the upper body can generate. It is an important area for performing police tasks requiring upper body strength. The score is a ratio of weight pushed divided by body weight Mile Run This is a timed run to measure the heart and vascular system's capability to transport oxygen. It is an important area for performing police tasks involving stamina and endurance and to minimize the risk of cardiovascular problems. The score is in minutes and seconds. MINIMUM PHYSICAL FITNESS PERFORMANCE ENTRANCE REQUIREMENTS CHART MALE AGE FEMALE AGE TEST < < Sit & Reach Minute Sit-Up Maximum Bench Press Ratio Mile Run 12:51 12:51 13:38 14:29 15:26 15:26 15:26 15:57 16:58 17:54 *Includes a 3% error-factor for males and 4o/o error-factor for females. WHAT ARE THE STANDARDS? The actual performance requirements for each test is based upon norms for a national population sample. The applicant must pass every test. The required performance to pass each test is based upon sex and age (decade). While the absolute performance is different for the 8 categories, the relative level of effort is identical for each age and sex group. All recruits are being required to meet the same percentile rank in terms of their respective age/sex group. The performance entrance requirement is that level of physical performance that equates to the 40th percentile for each age and sex group. The performance graduation requirement is that level of physical performance that equates to the 50th percentile for each age and sex group.

19 George Arruda Chief of Police Town of Swansea, Massachusetts Police Department 1700 GAR Highway Swansea, Massachusetts Telephone (508) Fax (508) To The Applicant: Please complete this form, sign it in the presence of a Notary Public and present it to your physician prior to your physical examination. Also, present the enclosed copy of the minimum physical fitness requirements to your physician prior to your physical examination. I, (Print your Name), have read the minimum physical fitness requirements for candidacy to the Swansea Police Department, I wish to maintain my candidacy and undergo the physical fitness examination. For these purposes, I agree as follows: 1. To undergo, at my own expense, a physical examination conducted by a physician of my own choosing, who is licensed to perform such physical examinations relevant to my ability to undergo the physical fitness examination required of candidates to the Swansea Police Department, and 2. To present this form and the enclosed copy of the minimum physical fitness requirements to my chosen physician prior to my physical examination. RELEASE I, (Print your Name), hereby state that I volunteer to undertake the physical fitness test administered by the Swansea Police Department in order to maintain my candidacy to said Department according to the Minimum Physical Fitness Requirements presented to me this day, AND I THEREFORE RELEASE AND ASSOLVE THE TOWN OF Swansea AND THE CHIEF OF POLICE, their designees, assigns and successors in interest from any and all liability whatsoever which may result from, or be in any way related to my participation in said minimum physical fitness requirements test at any time now or in the future. IN WITNESS WHEREOF, I give this release knowingly and of my own free will hereby binding myself, and my heirs, assigns, executors and administrators. SIGNATURE DATE Subscribed and sworn before me, this day of NOTARY PUBLIC MY COMMISSION EXPIRES

20 FITNESS TEST CERTIFICATE YOU MUST PRESENT THIS COMPLETED FORM AT THE FITNESS TEST Dear Physician: The following named individual has submitted an application to become a Swansea Police Officer: (To be completed by the applicant) NAME: The Swansea Police Department required each candidate to bring a completed fitness test certificate to the fitness test before he/she will be allowed to participate in this test. A statement must be obtained from a licensed physician that the candidate is of sufficient physical conditioning to undergo a physical fitness test. Enclosed in this package is a listing and description of the individual events and the minimum physical fitness standards a recruit must attain (Appendix A). We ask that your evaluation be based upon this criteria. In the event this applicant successfully competes this fitness test, a medical examination (post conditional offer- of employment) will be conducted at our expense, by a physician designated by the Swansea Police Department. Thank you for your assistance. PHYSICIAN STATEMENT: I have examined the above-named individual on (Date) I find him/her to be in sufficient physical conditioning to allow the applicant named above to participate in the Swansea Police fitness test. COMMENTS (If Any): Physician's Signature Please Type or Print: Physician's Name: Address: Telephone Number:

21 George Arruda Chief of Police - Town of Swansea, Massachusetts Police Department 1700 GAR Highway Swansea, Massachusetts Telephone (508) Fax (508) The information solicited in this application for employment is necessary to complete your background investigation. In order for the Swansea Police Department to have sufficient information to complete this investigation, you must complete this application in its entirety. The information solicited herein and the results of the investigation that follow will be used to determine your suitability for employment with the Swansea Police Department. You should be aware that willfully making a false statement or concealing any material fact in your application for employment will be the basis for dismissal from the selection process or from the Swansea Police Department, if later discovered. The Swansea Police Department maintains regularly scheduled night shifts. I understand that I must be available for such assignments as the needs of the Department might require. I further understand that any appointments tendered me will be contingent upon the results of a complete character and fitness investigation. I am aware that willfully withholding information or making false statements on this application will be the basis for dismissal from the selection process or from the Swansea Police Department, if later discovered. I agree to these conditions and hereby certify that all statements made by me on this application are true and complete to the best of my knowledge. SIGNATURE OF APPLICANT Subscribed and sworn before me, this day of NOTARY PUBLIC MY COMMISSION EXPIRES

22 George Arruda Chief of Police Town of Swansea, Massachusetts Police Department GAR Highway Swansea, Massachusetts Telephone (508) Fax (508) AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION I,, do hereby authorize a review of and full disclosure of all records, or any part thereof, concerning myself, by and to duly authorized agent of the Swansea Police Department, whether the said records are of a public, private, or confidential nature. The intent of this authorization is to give my consent for full and complete disclosure of the records of educational institutions; financial or credit institutions, including records of deposits, withdrawals and balances of checking and savings accounts, and loans, and also the records of commercial or retail credit agencies (including credit reports and/or ratings); medical and psychiatric treatment and/or consultation, including hospitals, clinics, private practitioners, and the U.S. Veteran's Administration; public utility companies; employment and pre-employment records, including background reports, efficiency ratings, complaints or grievances filed by or against me and salary records; housing records; real and personal property tax statements and records, and other financial statements and records wherever filed; records or complaint, arrest, trial and/or convictions for alleged or actual violations of law, including criminal and/or traffic records; records of complaints of a civil nature made by recollections of attorneys at law, or of other counsel, whether representing me or another person in any case in which I presently have, or have had an interest. I reiterate and emphasize that the intent of this authorization is to provide full and free access to the background and history or my personal life, for the specific purpose of pursuing a background investigation that may provide pertinent data for the Swansea Police Department to consider in determining my suitability for employment by that Department. It is my specific intent to provide access to personal information, however personal or confidential it may appear to be, and the sources of information specifically enumerated above is not intended to deny access to any r.ecord not specifically identified herein. I understand that any information obtained by a personal history background investigation that is developed directly or indirectly, in whole or in part, upon this release authorization will be considered in determining my suitability for employment by the Swansea Police Department. I have had explained to me, and I full understand that refusal to grant this authorization will. not, of itself, constitute a basis.for rejection of my application. A photocopy or a facsimile (FAX) of this release form will be valid as an original hereof, even though the said photocopy does not contain an original writing of my signature. Signature: Address: Date of Birth: SS#: NOTARY PUBLIC MY COMMISSION EXPIRES