Wilkesboro Police Department Application Form

Date of Application mm/dd/ccyy
Social Security Number:
Full Name:
Present Address:
City:
State: Zip Code
Home Phone :
Work Phone
Are You at Least 20 years of age?
Do you have a high school diploma or equivalent?
The position you're applying for:
Have you previously been employed by this agency?
If considered for employment, what date would you be available for work?
Briefly describe your qualification skills for the position you applied for (list certifications for the field in which you are applying for; example BLET Certified)
If applying for Police Officer position, do you currently hold a NC BLET Certification?
Present Employer's Name
Present Employer's  Address
Present Employer's City
Present Employer's State   Zip Code
Present Employer's Phone Number

List at least three references (include names, addresses and phone numbers (not former Employers or Relatives.

Reference #1
 Name
Address
City
 State   Zip Code
Phone Number
Reference #2
 Name
Address
City
 State   Zip Code
Phone Number
Reference #3
 Name
Address
City
 State   Zip Code
Phone Number

By clicking on the submit button you certify that the above information contained herein is accurate and truthful to the best of your knowledge, and you understand that any false information shall lead to the immediate disqualification as a potential employee of this agency.