Hernando County Sheriff's Office
Non-Emergency Call   1-352-754-6830
Apply for Level II Volunteer

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Level II Volunteer
ID:1002
Location:N/A
Department:Administrative
Resume
Resume:
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  - or Upload from:
 
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Level 2 Volunteer Application
All responses are required. If a question is not applicable, please enter N/A.
The Sheriff's Office is an Equal Employment Opportunity Employer. We consider applicants for all positions without regard to race, color, national origin, sex, age, disability, marital status, religion or any other legally protected status.
NOTICE: The following additional documents must be attached to this application:
  1. A copy of your birth certificate
  2. A copy of your Driver's License
  3. A copy of your Social Security Card
INSTRUCTIONS
All questions must be answered. Applications which are not complete will not be considered. If space provided is not sufficient for complete answers or you wish to furnish additional information, attach sheets of the same size as this application, and number answers to correspond with questions.
I understand that the submission of this application is for a voluntary position.
PERSONAL HISTORY
1. Full Name
2. Other: List all other names you have used including the circumstances and time periods you used them (For example: maiden name, former name(s), alias(es) or nickname(s).
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If yes, please complete the following
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If yes, please complete the following
 
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BACKGROUND INFORMATION
THIS INFORMATION IS REQUIRED TO CONDUCT BACKGROUND INVESTIGATION ONLY!
1. Date and Place of Birth:
 
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If naturalized, please provide:
Married   Divorced   Separated   Widowed   Never Married
 
5. Indicate any foreign languages you can speak
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EMPLOYMENT HISTORY
1. List chronologically 5 years' worth of employment, beginning with present employment, including summer and part-time employment while attending school. All time must be account for. If unemployed for a period of time please provide a reason.

Current or Most Recent Employer

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Previous Employer

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RESIDENCES
1. Actual places of residence for past 10 years - list chronologically all addresses, including residences while at school and in military. For college on campus residences, give dormitory name, city and state. If residences in military service cannot be shown as street address, indicated complete military unit designation and location by city and state. If post office box, give location of post office.

Current Address

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Previous Address

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ARREST HISTORY/COURT DATA
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If yes to question #1, #2 OR #3, list all such matters even if not formally charged, or no court appearance, or found not guilty or nolo contendre to any charge for which adjudication was withheld, or matter settled by payment of fine or forfeiture of collateral. (Include your juvenile record and records of your arrest(s) which have been sealed, if any.)

Incident 1

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Incident 2

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Incident 3

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Incident involving Relative 1

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Incident involving Relative 2

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Incident involving Relative 3

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DRIVING HISTORY
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PERSONAL REFERENCES & ACQUAINTANCES
1. Personal References: Give three (3) references (not relatives, former or present employers, fellow employees or school teachers) who are responsible adults of reputable standing in their communities, such as property owners, business or professional men or women, who have known you well for at least the past five (5) years. If retired, give former occupation.

First Personal Acquaintance

Second Personal Acquaintance

Third Personal Acquaintance

CONFIDENTIAL EMPLOYEE HISTORY
THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL AND WILL NOT BE MADE AVAILABLE FOR PUBLIC INSPECTION.
1. Applicant's Current Address:
3. Spouse's Name and Address (if different):
4. Please provide name and address of next of kin or other person to be contacted in case of an emergency:
5. Please provide the name and address of your personal or family physician to be contacted in case of an emergency:
I understand that the "œApplicants Certification" applies in all respects to the responses provided in number 1-5 above in this "œConfidential Employee History."
APPLICANT'S CERTIFICATION
I understand that my volunteer status will be contingent upon the results of a complete background investigation. I am aware that any omission, falsification, misstatement or misrepresentation will be the basis for my disqualification as a volunteer or my dismissal from the Sheriff's Office. I agree to the conditions and certify that all statements made by me on this application are true, correct and complete, to the best of my knowledge. I also understand that I will be fingerprinted. I understand that this volunteer application shall become the property of the Sheriff's Office and that it and the information received in response to the background examination are public records.
I understand that the use of drugs or alcohol is not permitted, during work or volunteer time, in the areas, including vehicles, where work is performed by employees or appointees.
I authorize any of the persons or organizations referenced in this application to furnish information, personal or otherwise, regarding my ability and fitness for volunteering with the Sheriff's Office and I release all such parties from any and all liability for any damage that might result from furnishing such information to the Sheriff's Office.
I agree to conform to the rules, regulations and orders of the Sheriff's Office and acknowledge that these rules, regulations and orders may be changed, interpreted, withdrawn or added to by the Sheriff's Office, at its discretion, at any time and without any prior notice to me.
I understand an investigation will be conducted on all of the information listed on this application. Because of this, I certify that I am not aware of any information about myself or any person with whom I am or have been closely associated (including relatives, roommates), which might tend to reflect unfavorably on my reputation, morals, character or ability that has not been previously disclosed.
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
I Choose Not to Respond
Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
American Indian or Alaska Native (Not Hispanic or Latino)
Black or African American (Not Hispanic or Latino)
Black or African American (Not Hispanic or Latino)
Hispanic or Latino
Hispanic or Latino
Asian (Not Hispanic or Latino)
Asian (Not Hispanic or Latino)
White (Not Hispanic or Latino)
White (Not Hispanic or Latino)
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
Two or More Races (Not Hispanic or Latino)
Two or More Races (Not Hispanic or Latino)
I Choose Not to Respond
I Choose Not to Respond
Veteran Status: (Please check all that apply)
Individual with a Disability
An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
I Choose Not to Respond


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