__________ _____ 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. Application must be hand written.
Position applying for:
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 mis-state or 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. Application must be hand written by applicant, do not type.
NAME ____________________________________________ DATE OF BIRTH_________________________________
HAVE YOU EVER BEEN DENIED A DRIVERS’S LICENSE OR HAD YOUR LICENSE SUSPENDED OR REVOKED? ____________________________
If yes, explain fully_____________________________________________________________________________________
YOU EVER SERVED IN THE
HIGHEST RANK RECEIVED_________________________ RANK AT DISCHARGE______________________________