Baker County

Sheriff's Office

3410 K Street

Baker City, OR  97814

(541) 523-6415

Fax (541) 523-9219

 

                                                                                                              Mitchell Southwick, Sheriff

 

 

 

Baker County is an equal opportunity employer and is dedicated to a policy of non-discrimination in employment because of race, sex, national origin, age, mental or physical disability, unless based upon a bona fide occupational qualification.

 

BAKER COUNTY SHERIFF’S OFFICE EMPLOYMENT APPLICATION

 

Position applying for:

____Civil Deputy        ____Corrections Deputy         ____Patrol Deputy     

____Marine Deputy    ____ Corrections Sergeant       ____ Reserve Deputy  

____Sergeant               ____ Corrections Corporal     ____Parole/Prob. Officer

 

DIRECTIONS:   Supply an answer to every question.  If a question is not applicable to you, write N/A.  If additional space is needed, use the back of the page.  Because this application is going to be used for investigation purposes, DO NOT omit material facts as the statements made herein are subject to verification to determine your qualification for employment.  Applications, which are illegible or incomplete, will not be considered.  

 

NAME: ____________________________________________   DOB:_________________________________

 

 

PRESENT ADDRESS:________________________________________________________________________________________________________________________________________________________________________________

 

PREVIOUS ADDRESS:________________________________________________________________________________________________________________________________________________________________________________

 

PHONE NO.:_________________________________    

SOCIAL SECURITY NO.:__________________________________

E-MAIL ADDRESS:________________________________

HEIGHT:____________   WEIGHT:_______________   

ARE YOU A U.S. CITIZEN?:________________________________

OREGON DRIVERS LICENSE NUMBER:________________________________________  

HAVE YOU EVER BEEN DENIED A DRIVERS’S LICENSE OR HAD YOUR LICENSE SUSPENDED OR REVOKED?: ____________________________

 If yes, explain fully:_____________________________________________________________________________________

_____________________________________________________________________________________________

 *********************************************************************************************

 

HAVE YOU EVER SERVED IN THE U.S. ARMED FORCES?:________________   

BRANCH:_________________________

 

DATES OF DUTY: ________________ To _________________

TYPE OF DISCHARGE:____________________________ (please include copy of DD214)

 

HIGHEST RANK RECEIVED:_________________________

RANK AT DISCHARGE______________________________

RATE/JOB IN MILITARY:_______________________________________________________________________________

ARE YOU PRESENTLY A MEMBER OF THE U.S. MILITARY RESERVE OR NATIONAL GUARD?:_________________

 *********************************************************************************************

 

NAME AND LOCATION OF HIGH SCHOOL: __________________________________________________________

__________________________________________________________

GRADUATE:__________________ GED: ______________________ DATE:_______________________________________

 

LIST ALL COLLEGES AND UNIVERSITIES ATTENDED:____________________________________________________

_____________________________________________________________________________________________

 

_____________________________________________________________________________________________

 

COLLEGE CREDITS:_______________ DEGREES:_____________________

FIELDS OF STUDY: ___________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

 

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LIST ANY SPECIAL TRAINING, LANGUAGES, CERTIFICATIONS, OR LICENSES YOU MAY HAVE THAT ARE PERTINENT TO THE POSITION FOR WHICH YOU ARE APPLYING.  INCLUDE INSTITUTION NAMES, ADDRESSESAND PHONE NUMBERS:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

 

DO YOU USE, OR HAVE YOU EVER USED ANY NARCOTICS OR DRUGS OTHER THAN THOSE PRESCRIBED TO YOU BY A PHYSICIAN?:_____________  

If yes, explain fully:______________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

HAVE YOU EVER BEEN CHARGED AND/OR CONVICTED OF A CRIME, BY EITHER A CIVILIAN AUTHORITY OR MILITARY AUTHORITY?: _______________

If yes, explain fully:_____________________________________________________________________________________

_____________________________________________________________________________________________

 

LIST ALL HOBBIES, ACTIVITIES AND INTERESTS:________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

LIST ALL ORGANIZATIONS YOU CONSIDER YOURSELF A MEMBER OF (civic clubs, fraternal orders and etc.)  INCLUDE ADDRESSES AND NAME OF PERSONS TO CONTACT AND PHONE NUMBERS:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

 

 

 


EMPLOYMENT HISTORY – BEGIN WITH YOUR PRESENT OR MOST RECENT JOB

 

 

EMPLOYER:______________________________________________________

FROM:_____________ TO:______________

 

ADDRESS:________________________________________

 EMPLOYER PHONE #:________________________________

 

JOB TITLE:__________________________

SUPERVISOR’S NAME & CONTACT NUMBER:_____________________________________________

 

SPECIFIC DUTIES:_____________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

REASON FOR LEAVING: _______________________________________________________________________________

 

 *********************************************************************************************

 

EMPLOYER:______________________________________________________

FROM:_____________ TO:______________

 

ADDRESS:________________________________________

EMPLOYER PHONE #:________________________________

 

JOB TITLE:__________________________

SUPERVISOR’S NAME & CONTACT NUMBER:_____________________________________________

 

SPECIFIC DUTIES:_____________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

REASON FOR LEAVING: _______________________________________________________________________________

 

*********************************************************************************************

 

EMPLOYER:______________________________________________________ FROM:_____________  TO:______________

 

ADDRESS:________________________________________

EMPLOYER PHONE #:________________________________

 

JOB TITLE:__________________________

SUPERVISOR’S NAME & CONTACT NUMBER:_____________________________________________

 

SPECIFIC DUTIES:_____________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

REASON FOR LEAVING: _______________________________________________________________________________

 

*********************************************************************************************

 

EMPLOYER:______________________________________________________

FROM:_____________ TO:______________

 

ADDRESS:________________________________________

EMPLOYER PHONE #:________________________________

 

 

JOB TITLE:__________________________

SUPERVISOR’S NAME & CONTACT NUMBER:_____________________________________________

 

SPECIFIC DUTIES:_____________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

REASON FOR LEAVING: _______________________________________________________________________________

 

*********************************************************************************************

 

 

EMPLOYER:______________________________________________________

FROM:_____________ TO:______________

 

ADDRESS:________________________________________

EMPLOYER PHONE #:________________________________

 

JOB TITLE:__________________________

SUPERVISOR’S NAME & CONTACT NUMBER:_____________________________________________

 

SPECIFIC DUTIES:_____________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

REASON FOR LEAVING: _______________________________________________________________________________

 

 

 

*********************************************************************************************

 

 

 

 

HAVE YOU EVER BEEN DISCHARGED FROM EMPLOYMENT OR ASKED TO RESIGN?:________________________

 

If yes, explain fully:______________________________________________________________________________________

 

_____________________________________________________________________________________________

 

_____________________________________________________________________________________________

 

DO YOU HAVE ANY OBJECTIONS OR PROBLEMS WITH WORKING NIGHTS?:  ______________________________

 

WEEKENDS? ______________  HOLIDAYS?  ____________________

ROTATING SHIFT WORK? _________________

 

*********************************************************************************************

 

 

LIST NAME, ADDRESS AND TELEPHONE NUMBERS OF THREE REFERENCES WHO ARE NOT RELATED TO YOU AND ARE NOT PREVIOUS EMPLOYERS:_________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

 

 

 

 

 ***Please submit all applications and supporting documentation to: ***

 

Baker County Sheriff’s Office at 3410 K Street  Baker City, Oregon 97814

OR

Baker County Parole and Probation at 2610 Grove Street  Baker City, Oregon  97814

 

 


APPLICANT’S CERTIFICATION AND RELEASE

 

 

I hereby certify that all statements made in this application or appended to it are true and correct to the best of my knowledge.  I am aware that withholding pertinent information or information found to be materially (grossly) inaccurate will be cause for refusing further consideration of my application, or will constitute grounds for my termination if I am employed.  I understand this is not to be considered as an indication of probable obligation upon the department to make an appointment, but a part of the selection process only.  I understand that failure on my part to notify the Sheriff’s Department of a change of address within thirty (30) days may subject my file to being closed.

 

Authority to Release Credit, Character, School Records, Personal History and Medical Information.

 

Having made application with the Baker County Sheriff’s Office, I hereby authorize a complete investigation of my record including personal history, school and academic records, military records, job performance, driving record and criminal arrest and conviction by the Baker County Sheriff’s Office or another police agency authorized to conduct their applicant investigation, to ascertain any and all information which may concern my credit and character, whether same is of record or not; and release your organization and all persons whomsoever from any charge because of furnishing said information.  I hereby acknowledge that I am aware the results of this investigation are confidential for Baker County Sheriff’s Office use only and will not be disclosed to myself or any other person without proper authorization.

 

_____________________________________________________________

 NAME (Print or Type)

 

                                                                                                                                                

 _______________________________________________________________

Signature                                            Date

 

All inquiries on Baker County Sheriff’s Office Applicants should be directed to:

 

                                       Baker County Sheriff’s Office

3410 K Street

Baker City, OR 97814

(541) 523-6415, Fax (541) 523-9219

 

Baker County Sheriff’s Office is an Equal Opportunity Employer

 

 

 

 

***SUPPLEMENTAL APPLICATION QUESTIONS***

(to be submitted with application and release for background investigation)

 

 

1.  Please detail your education, training and knowledge of offender case planning, starting with an offender’s conviction (starting of supervision) through case expiration.

 

 

 

 

2.  Explain your knowledge of evidence-based risk assessment tools and how they apply to case management.

 

 

 

 

3.  Identify any experience you have in facilitating offender education/treatment groups as well as the benefits and pitfalls of such programs.

 

 

 

 

4.  Detail your ability to work within a team environment and the challenges that may come from this type of work setting.

 

 

 

VOLUNTARY SURVEY

 

AFFIRMATIVE ACTION – NON DISCRIMINATION

 

Periodically we may be required to file reports on the sex, ethnicity, disability, veteran and other protected status of employees.

This data is collected to enable us to comply with Affirmative Action responsibilities and other legal requirements.

YOUR PARTICIPATION IN THIS SURVEY IS STRICTLY VOLUNTARY.

Name

 

Social Security Number

 

Check One

Check one

Male

Female

White

Black

Hispanic

American Indian/Alaskan Native

 

Asian/Pacific Islander

Other