File Hills First Nations Police Service
EMPLOYMENT
APPLICATION
MAILCOMPLETEDAPPLICATIONTO:
FILE HILLS FIRST NATIONS POLICESERVICERECRUITINGUNIT
Box460
Balcarres, Sask. S0G 0C0
FormoreinformationaboutopportunitieswiththeFile Hills First Nations PoliceService
1.AnessentialcomponentintheselectionprocessoftheFile Hills First NationsPoliceServiceisabackgroundinvestigation.InformationgatheredwillbeusedtoassessthesuitabilityoftheApplicant forapolicecareer.Therewill beasecuritycheckontheApplicantandmembersoftheirfamily.
2.Allquestionsmustbeanswered.Ifaquestionisnotapplicable,markN/A.attachanoteexplainingthereasonanyquestionisleftblank.
3.Allinformationsuppliedissubjecttoverificationbyinvestigation.Falsestatementscandisqualifyorresultindismissalifemployed.
4.Completethisformbyprintinginink.Neatnessandlegibilityareoftheutmostimportance.
5.Ifextraspaceisrequired,attachadditionalpagestothisapplication.
6.Postalcodesmustbesuppliedforeachaddressgiven.
7.Noinformationreceivedfrominquiriesconcerninginformationinthisapplicationwillbereleasedtotheapplicant.
Alloftheitemsbelowmustbesubmittedwithyourapplication:CopyofHighSchoolDiplomaPardon(ifapplicable)
CertifiedcopyofHighSchoolTranscriptCopyofVisionReport
CompletedPersonalDisclosureFormCopy ofHearingReport
DrivingRecordAbstract–lastthreeyearsPost-SecondaryDocuments(ifapplicable)(OutofProvinceApplicantsmustsupplytheirProvincialEquivalent)
CopyofBirthCertificateand/orCanadianCitizenshiporLegalPermanentResidentdocumentation
Copy of CertificateofStandardFirst Aid–certifiedwithinthelast 36months
CopyofCertificateinCardiopulmonaryResuscitation(CPR)“LevelB”–certifiedwithinthelast12months
ApplicantswithoutStandardFirstAidorCPRshouldcheckwiththeindividualpoliceagencyhe/sheisapplyingtoforadditionalinformationonhowtomeetthisrequirement…
LASTNAME / GIVENNAME / MIDDLENAME
FULLADDRESS / CITY / PROVINCE / POSTALCODE
EMAILADDRESS / TELEPHONE NO.(RES.)
[] / TELEPHONE NO.(BUS.)
[] / TELEPHONENO. (OTHER)
[]
Otherthanthename(s)listedabove,pleaselistanynamechange(s),orname(s)youmayhaveusedinthepast.
NAMECHANGEFROM: / NAME CHANGETO: / DATEOFCHANGE
YYYY / YYYY / YYYY
DRIVER’SLICENCE / PROVINCE / CLASS(ES) / LICENCENUMBER / DATE OFISSUE
YYYY / MM / DD
PersonalinformationonthisEmploymentApplicationisbeingcollectedundertheauthorityoftheFreedom ofInformationProtectionofPrivacyAct (FOIPP)Section33(c). Itwillbeusedtodetermineyoursuitability,eligibilityorqualificationsforemployment.QuestionsabouttheuseorcollectionofthisinformationshouldbedirectedtotheFOIPProgramAdministrator.
TheHumanResourcesUnitisconstantlyreviewingrecruitinginitiativesacrossCanada.Toassistuswithourfutureplanning,pleaseindicatehowyoulearnedaboutthisemploymentopportunity:
CareerFairNewspaperRadio/T.V.CollegePostingPoliceOfficerOther
EDUCATIONANDTRAININGProofofeducationwillberequiredpriortoengagement
HIGHSCHOOL
Circlehighestgradecompleted
NAMEOFSCHOOLLOCATION
HIGHSCHOOLDIPLOMA
10111213
COLLEGE,BUSINESSSCHOOL,ORTECHNICALSCHOOL
PROGRAMORCOURSE
NAMEOFSCHOOLLOCATION
EQUIVALENCYDIPLOMA
STARTDATEFINISHDATE
YYYYMMYYYYMM
LENGTHOFCOURSE
GRADEPOINTAVERAGE
CERTIFICATE,DIPLOMA,ORLICENCEAWARDED?(IFNOT–PLEASEPROVIDEDETAILS)
YESNO
COLLEGE,BUSINESSSCHOOL,ORTECHNICALSCHOOL
PROGRAMORCOURSE
NAMEOFSCHOOLLOCATION
STARTDATEFINISHDATE
YYYYMMYYYYMM
LENGTHOFCOURSE
GRADEPOINTAVERAGE
CERTIFICATE,DIPLOMA,ORLICENCEAWARDED?(IFNOT–PLEASEPROVIDEDETAILS)
YESNO
NAMEOFSCHOOLLOCATION
UNIVERSITY
PROGRAMORCOURSE
STARTDATEFINISHDATE
YYYYMMYYYYMM
MAJOR/MINOR
LENGTHOFCOURSE
GRADEPOINTAVERAGE
CERTIFICATE,DIPLOMA,ORDEGREEAWARDED? (IFNOT–PLEASEPROVIDEDETAILS)
YESNO
NAMEOFSCHOOLLOCATION
UNIVERSITY
PROGRAMORCOURSE
STARTDATEFINISHDATE
YYYYMMYYYYMM
MAJOR/MINOR
LENGTHOFCOURSE
GRADEPOINTAVERAGE
CERTIFICATE,DIPLOMA,ORDEGREEAWARDED? (IFNOT–PLEASEPROVIDEDETAILS)
YESNO
NAMEOFSCHOOLLOCATION
UNIVERSITY
PROGRAMORCOURSE
STARTDATEFINISHDATE
YYYYMMYYYYMM
MAJOR/MINOR
LENGTHOFCOURSE
GRADEPOINTAVERAGE
CERTIFICATE,DIPLOMA,ORDEGREEAWARDED? (IFNOT–PLEASEPROVIDEDETAILS)
YESNO
I.Q.A.S.
(InternationalQualificationsAssessmentStandards–Certificate-ifapplicable)
ForInternationalapplicantsonly–Pleasestatethehighestleveleducationachieved.
NAMEOFSCHOOLLOCATION
PROGRAMORCOURSE
STARTDATEFINISHDATE
YYYYMMYYYYMM
MAJOR/MINOR
LENGTHOFCOURSE
GRADEPOINTAVERAGE
CERTIFICATE,DIPLOMA,ORDEGREEAWARDED? (IFNOT–PLEASEPROVIDEDETAILS)
YESNO
LANGUAGESSPOKEN
LANGUAGESWRITTEN
ADDITIONALEDUCATIONINCLUDINGCOURSES,WORKSHOPS,ANDSEMINARS.(ATTACHANADDITIONALPAPERIFNECESSARY)ADDITIONALCOMPUTERSKILLS,TRAINING,COURSES,ETC…(ATTACHANADDITIONALPAPERIFNECESSARY)
HAVEYOUEVERWRITTENTHECAAT(CANADIANADULT ACHIEVEMENTTEST),ORTHEWCT(WRITTENCOMMUNICATIONTEST)?YES(if YES –Where When) NO
HAVEYOUEVERWRITTENTHERCMP Entrance EXAM (RPAB) or other equivalent test?YES(ifYES –Where When)NO
HAVEYOUEVERAPPLIEDFORAPOSITIONWITHTHISORANYOTHERPOLICEAGENCY?YES(ifYES–WhereWhen)NO
LISTALLAPPLICATIONSTOTHISORANYOTHERPOLICEAGENCIES
POLICEAGENCY / APPLICATIONDATE
YYYYMMDD / STATUS(describereasonfornon-selection)
HAVEYOUEVERTAKENAPOLYGRAPHORCOMPUTERVOICESTRESSANALYSISEXAMINATION?YESNO
AGENCYWHEREPOLYGRAPHORCOMPUTERVOICESTRESSANALYSISEXAMINATIONWASCOMPLETED / YYYYMMDD
REASONFORPOLYGRAPHORCOMPUTERVOICESTRESSANALYSISEXAMINATION
HAVEYOUEVERBEENFINGERPRINTED?YESNO
REASONFORFINGERPRINTING
Beginwithyourmostrecentemployerandcontinueinreversetimeorder.
EMPLOYMENT HISTORYProvidehistoryforthelastten(10)yearsifapplicable.
Provideanexplanationforallgapsinemployment.
MOSTRECENT / EMPLOYER’SNAME / TELEPHONENUMBER
[]
EMPLOYER’SADDRESS / POSTALCODE
NAMEOFIMMEDIATESUPERVISOR / TELEPHONENUMBER
[]
STARTDATE / FINISHDATE / POSITIONHELD
YYYY / MM / YYYY / MM
DUTIES/RESPONSIBILITIES
REASONFORLEAVING
2nd / EMPLOYER’SNAME / TELEPHONENUMBER
[]
EMPLOYER’SADDRESS / POSTALCODE
NAMEOFIMMEDIATESUPERVISOR / TELEPHONENUMBER
[]
STARTDATE / FINISHDATE / POSITIONHELD
YYYY / MM / YYYY / MM
DUTIES/RESPONSIBILITIES
REASONFORLEAVING
3rd / EMPLOYER’SNAME / TELEPHONENUMBER
[]
EMPLOYER’SADDRESS / POSTALCODE
NAMEOFIMMEDIATESUPERVISOR / TELEPHONENUMBER
[]
STARTDATE / FINISHDATE / POSITIONHELD
YYYY / MM / YYYY / MM
DUTIES/RESPONSIBILITIES
REASONFORLEAVING
EMPLOYMENTHISTORY(Continued)
4th / EMPLOYER’SNAME / TELEPHONENUMBER
[]
EMPLOYER’SADDRESS / POSTALCODE
NAMEOFIMMEDIATESUPERVISOR / TELEPHONENUMBER
[]
STARTDATE / FINISHDATE / POSITIONHELD
YYYY / MM / YYYY / MM
DUTIES/RESPONSIBILITIES
REASONFORLEAVING
5th / EMPLOYER’SNAME / TELEPHONENUMBER
[]
EMPLOYER’SADDRESS / POSTALCODE
NAMEOFIMMEDIATESUPERVISOR / TELEPHONENUMBER
[]
STARTDATE / FINISHDATE / POSITIONHELD
YYYY / MM / YYYY / MM
DUTIES/RESPONSIBILITIES
REASONFORLEAVING
IFYOUWEREASKEDTORESIGN,ORWEREFIREDFROMAJOB,ORHADAGAPINEMPLOYMENT,PLEASEPROVIDEDETAILSANDEXPLANATIONS.
NAME / GIVENNAMES / RELATIONSHIP
FULLADDRESS / POSTALCODE
TELEPHONENO.(RES.)
[] / TELEPHONENO.(BUS.)
[] / OCCUPATION / YEARSKNOWN
NAME / GIVENNAMES / RELATIONSHIP
FULLADDRESS / POSTALCODE
TELEPHONENO.(RES.)
[] / TELEPHONENO.(BUS.)
[] / OCCUPATION / YEARSKNOWN
NAME / GIVENNAMES / RELATIONSHIP
FULLADDRESS / POSTALCODE
TELEPHONENO.(RES.)
[] / TELEPHONENO.(BUS.)
[] / OCCUPATION / YEARSKNOWN
NAME / GIVENNAMES / RELATIONSHIP
FULLADDRESS / POSTALCODE
TELEPHONENO.(RES.)
[] / TELEPHONENO.(BUS.)
[] / OCCUPATION / YEARSKNOWN
NAME / GIVENNAMES / RELATIONSHIP
FULLADDRESS / POSTALCODE
TELEPHONENO.(RES.)
[] / TELEPHONENO.(BUS.)
[] / OCCUPATION / YEARSKNOWN
CREDIT HISTORYPleasecompletethefollowinginformation.
NAME
MAIDENNAME/OTHERNAMESUSED
DATEOFBIRTH
YYYYMMDD
EMPLOYER’SNAME
CURRENTADDRESS
FROMTO
YYYYMMDDYYYYMMDD
CITYPROVINCECOUNTRYPOSTALCODE
PREVIOUSADDRESS
FROMTO
YYYYMMDDYYYYMMDD
CITYPROVINCECOUNTRYPOSTALCODE
PREVIOUSADDRESS
FROMTO
YYYYMMDDYYYYMMDD
CITYPROVINCECOUNTRYPOSTALCODE
PREVIOUSADDRESS
FROMTO
YYYYMMDDYYYYMMDD
CITYPROVINCECOUNTRYPOSTALCODE
DRIVER’SLICENCE
CREDITCARDS
PROVINCECLASS(ES)LICENCENUMBER
TYPEISSUINGINSTITUTIONCURRENTBALANCEOWING
DATE OFISSUE
YYYYMMDD
EXPIRATIONDATE
YYYYMM
TYPEISSUINGINSTITUTIONCURRENTBALANCEOWING
2
EXPIRATIONDATE
YYYYMM
TYPEISSUINGINSTITUTIONCURRENTBALANCEOWING
3
EXPIRATIONDATE
YYYYMM
TYPEISSUINGINSTITUTIONCURRENTBALANCEOWING
4
EXPIRATIONDATE
YYYYMM
OFFICEUSEONLY
FILEMANAGER
DATESENT(Fax)
YYYYMMDD
DATERECEIVED(Fax)
YYYYMMDD