Henderson County Sheriff Application

Position Applied For:*

Deputy Court Security Officer Office Help

Date Appyling:

Last Name*

First Name*

Middle Initial:

Street Address:*

City:*

State:*

Phone Number:*

Date Of Birth:*

Social Security Number*

Email Address:*

Are You Now Employed*

Yes No

May we contact your employer?*

Yes No

United States Citizen?*

Yes No

Can you travel if the job requires?*

Yes No

Have you been convicted of a felony?*

Yes No

Have you been convicted of a Misdemeanor*

Yes No

Do you have any traffic convictions?*

Yes No

Prior Law enforcement experience*

Yes No

Are you available full time?

Yes No

Military Service

Military Branch?

Start Date:

End Date?

List Of References

First Reference:

Full Name?*

Relationship?*

Name Of Company*

Phone Number?*

Street Address?*

City?*

State?*

Second Reference

Full Name?*

Relationship?*

Name Of Company*

Phone Number?*

Street Address?*

City?*

State?*

Third Reference

Full Name?*

Relationship?*

Name Of Company*

Phone Number?*

Street Address?*

City?*

State?*

Education

High School Attended:*

Street Address:*

City and State:*

Did you graduate?*

Yes No

College Attended:*

Street Address:*

City and State:*

Did you graduate?*

Yes No

Other Education:*

Street Address:*

City and State:*

Did you graduate?*

Yes No

Other Skills:

Described any specialized training, apprenticeships, skills, and any extra curricula activities:

Employment Experience

List your present or last job first. Include any job related military service assignments and volunteer activities. You may exclude organizations, which indicate race, color, religion, gender, national origin, handicap, disability, or other protected status.

Employer #1

Employer:*

Phone Number?

Job Title:*

Date Employed: From*

To:*

Street Address:*

City and State:*

Supervisor?*

Reason for Leaving?*

Employer #2

Employer:*

Phone Number?

Job Title:*

Date Employed: From*

To:*

Street Address:*

City and State:*

Reason for Leaving?*

Employer #3

Employer:*

Phone Number?

Job Title:*

Date Employed: From*

To:*

Street Address:*

City and State:*

Supervisor?*

Reason for Leaving?*