REQUIRED DOCUMENTS

You may attach these documents to your online application, mail or email to the address provided below within 7

business days from the date your online application was submitted. Your application will not be processed until this

information is received.

Forsyth County Sheriff’s Office

ATTN: Karleen Chalker, Recruitment

100 East Courthouse Square

Cumming, GA 30040

Or email to: KXChalker@forsythco.com

Submit copies of:

- Valid driver’s license.

- 7 year driver’s license history (MVR) - Georgia and/or other states within 7 years. Georgia MVR available, for a

fee, online at www.dds.ga.gov or the Georgia Department of Driver Services (DDS) office.

- Social Security card.

- Birth certificate OR passport.

- High school diploma OR certified high school transcripts OR GED.

- IF a college graduate your college degree or certified college transcripts.

- IF a Military Veteran, a copy of your DD214 Member 4 Copy with an Honorable Discharge ONLY.

- IF active or prior Law Enforcement in Georgia or in another state, a copy of your Peace Officer or Jailer

Certificate.

- A recent wallet-size or passport photograph of yourself, no copies will be accepted (no ball caps, hats or

sunglasses).

- A written, signed and notarized statement for any misdemeanors or felonies that you have been convicted of,

including any convictions under the First Offender Act.

- Attach a copy of any court dispositions that you have been charged with, convicted of or pled nolo to.

Instructions:

- If any information changes such as your name, mailing, physical, or email address, telephone number, or

employment status notify Karleen Chalker, Recruitment, immediately.

- Complete a 10-year chronological history of your employment.

- List all law enforcement employment even if more than 10 years ago.

- Complete the Forms 1-8 thoroughly with requested signatures and notarizations.

YOUR APPLICATION WILL NOT BE PROCESSED IF THERE ARE ANY INCOMPLETE DOCUMENTS.

STEPS IN THE HIRING PROCESS FOR CERTIFIED & CIVILIAN APPLICANTS

Deputy Sheriff I/Jailer: If you are not EXEMPT from taking the 4 part National Peace Officer Selection Test you will need to take the test at our agency. The 4 part test consists of Math, Reading Comprehension, Grammar and Incident Report Writing. If you do not pass ALL 4 parts of the test you will not continue with the hiring process at this time.

EXEMPTIONS: - College Degree of Associate’s or higher. - P.O.S.T. Certified Peace Officer certificate. - P.O.S.T. Certified Jailer or Corrections Officer certificate. - United States Military Veteran with an Honorable Discharge with completion of required active service –

Member 4 copy of DD214 accepted ONLY. YOU MUST PROVIDE THESE DOCUMENTS WITH YOUR ONLINE APPLICATION.

If you have any of the above listed EXEMPTIONS you DO NOT take the 4 part National Peace Officer Selection Test.

During the hiring process all Deputy Sheriff I/Jailers and Deputy Sheriff II/Patrol applicants: - Must pass the preliminary background investigation and all file reviews. - Must pass the physical agility test, be recommended after the supervisory interview and attend a jail tour (for

Deputy Sheriff I/Jailer). (The physical agility consists of chair to cone 160’, 4ft broad jump, climb 4ft fence, low crawl obstacle, 10 push-ups, 30 steps and dummy drag 25ft within the time limit of 2:30.)

- Must pass the polygraph, psychological, physical, audio and drug screen. - Must pass the Interview with Sheriff Ron H. Freeman. If you do not pass any of the above steps you will not continue on with the hiring process.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ During the hiring process all Civilian applicants: - Must pass the preliminary background investigation and all file reviews. - Must be recommended after the supervisory interview and attend a jail tour (if applying for a position held in

the Detention Center). Must pass the polygraph and drug screen.

- Must pass the Interview with Sheriff Ron H. Freeman. If you do not pass any of the above steps you will not continue on with the hiring process.

The Recruitment Unit will notify all Applicants/Candidates of the status of their application, required documents, scheduled tests and results throughout the hiring process. Applicants/Candidates not selected will be notified by email, telephone or in person of the decision made.

The hiring process will normally take four to six weeks once all of your requested documents are received, and

based on your availability for appointments.

FOR #1 SUBSTANCE ABUSE TESTING NOTICE

AUTHORIZATION AND RELEASE FOR FORSYTH COUNTY EMPLOYMENT APPLICANTS

"THIS DOCUMENT MUST BE SIGNED IN THE PRESENCE OF A WITNESS. THE WITNESS

CAN BE ANYONE INCLUDING FA JLY EMBERS ANO FRIENDS.

I hereby acknowledge that I have applied for employment with Forsyth County, Georgia, and I have been informed that a substance abuse test is required for this employment.

I agree to provide all necessary samples of body fluid and to otherwise cooperate in all respects with the collection and testing procedures.

I authorize the county physician or other responsible entities performing or assisting in the testing procedure to release the results of any substance abuse test to the Forsyth County Sheriff's Office and to Forsyth County.

I authorize the Forsyth County Sheriff's Office and Forsyth County to receive and review the results of any substance abuse test.

I realize that failure to appear at the designated time or failure to take the test or cooperate with the testing or collection procedure will disqualify me from further consideration for employment with the Forsyth County Sheriffs Office.

I HAVE CAREFULLY READ THIS DOCUMENT AND I UNDERSTAND THIS DOCUMENT,

Signature of Applicant "(Sign in the presence of a witness) Date

Printed name of Applicant

Social Security Number

Witness Signature

RevlHd 01 /08/15 FORSYTH COUNTY IS AN l!QUAL OPPORTUNITY EMPLOYER FORM#1

FOR ,#2 FORSYTH COUNTY SHERIFF'S OFFICE

AFFIDAVIT OF APPLICATION

As the applicant, I state that I understand and/or certify the following:

1. That if I do not wish to answer a question in the application process, I may do so; however, myapplication will not be processed.

2. Exclusive of the aforementioned statement, all information that is recorded in the application processwill be used in relation to consideration or qualification of the applicant for employment only, and noother purpose.

3. That I have read and understand all questions and instructions in this application and that my answersduring the application process are true and complete to the best of my knowledge and belief.

4. That truthful and complete responses in the application process are required.5. That discovery of intentional omissions or incorrect answers may be the basis for the termination of the

application process and may result in criminal prosecution for the offense of False Statements underGeorgia Code Section 16-10-20, a felony punishable by a maximum fine of $1,000.00 or imprisonmentof not less than one (1) or more than five (5) years, or both; or for the offense of False Swearing underGeorgia Code Section 16-10-7, a felony punishable by a maximum fine of $1,000.00 or imprisonment ofnot less than one (1) or more than five (5) years, or both.

6. That falsification during the application process by an individual hired may result in termination ofemployment with this agency.

7. That the Forsyth County Sheriff's Office operates within the scope of a Standard Operating Procedure(SOP) and if an offer of employment is made and accepted, the applicant agrees to work in accordancewith these policies and procedurt3s.

8. That all information provided will be verified either by interview, testing, psychological testing, medicalexamination, drug screening, polygraph examination, and/or computer verification of driver's/criminalhistory and driver's license status.

9. I understand that if offered employment, my probation period will be one year as stated in the ForsythCounty Civil Service Manual. rn the event I achieve agency work performance standards within theprobationary period, I will be classified as a regular employee. I also understand as I regularemployee, should my work performance fall below agency standards, that I may be disciplined, up to and including termination. I further understand that if I am terminated, I must return all property issuedto me by the Forsyth County Sheriff's Office, or make suitable restitution for same.

10. That I may be terminated for any good and sufficient cause, to include, but not limited to, criminalactivity or violation of Sheriff's Office policies and procedures. I understand that I may have appealrights as provided for in the Forsyth County Sheriff's Standard Operating Procedures Manual and theForsyth County Civil Service Manual.

Date

Before me personally appeared the above said person who says that he/she executed the above Affidavit of his/her own accord, with full knowledge of the purpose therefore.

Sworn to and subscribed before me this _____ day of __________ , 20 ____ _

Notary Public's Signature

(Place Commission Information and Seal)

FORM#3 AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION

AND CRIMINAL HISTORY RECORD INFORMATION

I, the undersigned, do hereby authorize the procurement, review and disclosure of all records concerning mysel· to any duly authorized officers or agents of the Forsyth County Sheriff's Office, whether said records are of a public private or confidential nature.

The intent of this authorization is to demonstrate my unconditional consent for the full and complete disclosun of records from educational institutions; financial or credit agencies including credit reports and/or ratings, and othe financial statements wherever filed; medical and psychiatric treatment and/or consultation including hospitals, clinics private practitioners, and the United States Veterans Administration; employment and pre-employment record� including internal investigations, reports, background reports, polygraph exam results, efficiency or fit-for-duty reports complaints, or grievances filed by or against me; all forms of social media network information; the records of m1 attorney(s) at law or other counsel, either crfmfnal or civil, that has/have represented me in any other matter which presently have or have had an interest; and any other document or article of information deemed pertinent by thE Forsyth County Sheriff's Office for the purposes of assessing the employment suitability of:

NAME OF APPLICANT (please printl: ____________________ _ Last First Middle I / Maiden Name

I understand that any Information obtained by a personal history background investigation, which is prepare< in reliance - in whole or in part - upon this Release will be considered in determining my suitability for employmen with the Forsyth County Sheriff's Office. I also certify that any person(s) or entities who may furnish informatior concerning me shall not be held accountable or liable for giving such information; and I hereby specifically release

such person(s) or entities from any and all llablllty which may or could be incurred as a result of furnishing suet information. I also relea�e Forsyth County and the Forsyth County Sheriff's Office from any and all liability associatec with the requesting and/or procuring of such information.

I hereby authorize the Forsyth County Sheriff's Office to receive any criminal history record information anc driver's history information pertaining to me or my spouse (If applicable) which may be in the files of any criminal justicE agency. A photocopy of the release form will be valid as an original thereof, even though said photocopy does no contain any original writing of my signature .

.. SIGN IN Tf·iE PRESENCE OF A NOT ARY PUBL:

APPLICANT'S SIGNATURE:••------------------------------

SEX: OPTIONAL: RACE ___ _ DATE OF B!RTH: ______ SSN: __________ _

ADDRESS: ____________________ DRIVER'S LICENSE# ________ _

SPOUSE'S NAME: (please print) _________________ MAIDEN. _________ _

SPOUSE'S SIGNATURE:•-------------------------------

SEX: OPTIONAL: RACE ___ ____ DATE OF BIRTH: SSN: ------- -----------

ADDRESS: ____________________ DRIVER'S LICENSE# _________ _

Sworn and subscribed in my presence this ___ day of ___________ , 20 __ _

Notary Public's Signature (Place Commission Information and Seal)

FORM#4 EMPLOYMENT NOTIFICATION AND ACKNOWLEDGMENT

The purpose of this release Is to allow the Forsvth County Sherj[s Office (referred to as ·company"). Proress1onal Screening & lnrormatlon, Inc. (PSI). or their ess gr,s, to obtain pre-empfoymenl Information as part or my application for employment, which may Include any lawful lnvesUgallon not llmlted 10 my educatronal. criminal, drlVlng, c<edlt. end employment histories. white maintaining compliance wlth al! governmental laws. I also consent to tile company obtaining such lnl'ormallon if I am employed by the company for any employment purpose.

I also agree that thia NoUficaUon and Acknowledgement in original, faxed, phot.ocopied, or electronic (including electronically signed) form will be vaHd for any consumer reports or investigative consumer reports that may be requested about me by or on behalf of the Company.

A copy of PSl's Privacy Policy can be found al 1uw;/twww.pllba945grpyndc114cx.com/gr!v1cy-paljcv shlmf.

CA, MN and OK N1sldlnta only: Check here If you would like to receive a copy of your report 0

I certify that the Information contained below la complete and true. I have read this Notillcalion and Acknowledgment, understand its terms, realize Its significance, consent to a background investigation as part of the application process and if employed, during my employment as well, and sign this form voluntarily.

ApplicantSignature: ________________ Oate: __________ _

THE INFORMATION BELOW BEING REQUESTED IS FOR BACKGROUND INVESTIGATION PURPOSES ONLY AND WILL NOT BE URD FOR ANY O™ER PURPOSE.

iP!NIPUl4ii

Full legal Name (As shown on SSN/1D Card):

First Name: ________ Middle Name: ____________ Last Name: ___________ _

Maiden Name (First, Middle, Laat):. _____________ Dates Used (from-to): ___________ _

Social Security Number: ____ _ ____ Date of Birth (Month-Day-Year): __ - __ - __ _

Driver's License#: ________ Stale: ___ Cell#:( ______ Home#:(

E-mail Address: _____________ ____ _

*(Optional): Race: _______ _ Sex: D Male O Female Position Applied For: _____________ _

curc,nt addr:ns

• Street: _________________________ _

City, State (County), Zip Code: _______________ _

ChronofogfcillllV list all pllilces of residence for ttte past ,even yea[!

• Street: _________________________ _

City, State (County), Zip Code: _______________ _

• Street: _________________________ _

City, State (County), Zip Code: _______________ _

• Street: _________________________ _

City, State (County), Zip Code:

Client: Forsv1h cauntv snodffa omce

Note:

Cr ,Mf-'AN Y U',E UNI Y

Month/Vear

From: ___________ _

To:

Mgnth/VHr

From: ___________ _

To:

From: ___________ _

To:

From: __________ _

To:

✓ PLEASE NOTE: For all Motor Vehicle Reports, a clear and legible copy of the applicant's driver's license is required.

�ORM#4

FORM#S FCRA Disclosure and Authorization ,,

• Under the FCRA (Fair Credit Reporting Act), before the Company can obtain a consumer reportor investigative consumer report about you for employment purposes, we must have your writtenauthorization.

• I am aware I have the right to make a written request to Professional Screening & Information,Inc., Post Office Box 644, Rome, Georgia 30162; call them colleot at 1-877-235-7574, or contactthem via the internet at www.psjbackgroundcheck.com to obtain a free copy of my backgroundinvestigation, within a reasonable period of time, If an employment decision has beenInfluenced by Information contained In • background lnvgtlgation report.

• In addition, a summary cf your rights wUI be made available to you under the Fair CreditReporting Act.

• California, Oklahoma, and Minnesota residents are entitled to a free copy of their consumerreport upon request and will be provided with a separate Notification and Acknowledgement formto complete.

By signing below I certify that I have carefully read and undel'lltand thi• Oiacloeure and Authorization.

Applicant Signature:. ______________ _

Date:. __________ _

FOR PERSONNEL USE ONLY FORM#S

, .,, FORM#6 SOCIAL REFERENCES

Applicant's Name

You mu1 t 11st five (5} people whom you know well and who live in the United States. They should be a good friend, peer, colleague or college roommate, whose combined association with you covers as much as possible of the last 10 years. DO NOT list your spouse, former spouse, or other relatives. DO NOT list anyone who is listed elsewhere in this application.

Incomplete information will result in a delay of your application process.

1. Complete Name (Last, Middle, First): Home Addru&:

Years Acquainted and Relationship: (City, Slate, Zip Code):

Cell Phone (Including Area Code): DOB or Approximate Age:

Alternate Phone (Including Area Code):

Occupation: Work Phone (Including Area Code):

2. Compfete Name (Last, Middle, First): Home Address:

Years Acquainted and Relationship: (City, State, Zip Code):

Cell Phona (Including Area Code): DOB or Approximate Age:

Alternate Phone (Including Area Code):

Occupatton: Work Phone (Including Area Code):

3. Complete Name (Lest, Middle, First): Home Address:

Years Acquainted and Relationship: (City, State, Zip Code):

Cell Phone (Including Area Code): DOB or Approximate Age:

Alternate Phone (Including Area Code):

Occupation: Work Phone (Including Area Code):

4. Complete Name (Last, Middle, First): Home Address:

Years Acquainted and Relationship: (City, State, Zip Code):

Cell Phone (Including Area Code): DOB or Approximate Age:

Alternate Phone (Including Area Code):

Occupation: Work Phone (lnclUdlng Area Code):

5. Complete Name (Last, Middle, First): Home Address:

Years Acquainted and Relationship: (City, State, Zip Code):

Cell Phone (Including Area Code): DOB or Approximate Age:

Alternate Phone (Including Area Code):

Occupation: Work Phone (Including Area Code)

FOR #7 NEIGHBOR REFERENCES

Applicant'• Name

You must list three (3) current or former neighbors. If you do not have any neighbors residing next

to you or across the street from you at your current address, vou mav uee people who live on the

same street as you, former neighbor references, landlords or roommates. You DO NOT have to

know the person, DO NOT list anyone who is listed elsewhere on this application.

lncompl�te information will result in a delay of your application process.

1. Complete Name (Last, Middle, First):Home Address:

Years Acquainted and Relationship: (City, State, Zip Code):

Approximate Age: Cell Phone (Including Area Code):

Alternate Phone (Including Area Code): Occupation;

Work Phone (Including Area Code):

2. Complete Name (Last, Middle, First):Home Address:

Years Acquainted and Relatlom1hip: (City, State, Zip Code):

Approximate Age: Cell Phone (Including Area Code):

Occupation: Alternate Phone (lnduding'Area Code):

Work Phone (Including Area Coda):

3. Complete Name (Last, Middle, First):Home Address:

Years Acquainted and Relationship: (City, State, Zip Code):

Approximate Age: Cell Phone (Including Area Code):

Alternate Phone (Including Area Code): Occupation:

Work Phone (Including Area Code):

I •. / _d,'�,11 OD�,.::--;-._

· 1ur FORM#8 FORSYTH COUNTY SHERIFF'S OFFICE

� SOCIAL MEDIA INFORMATION REQUEST

As part of the application and background investigation process, the Forsyth County Sheriff's Office requires access to each applicant's social media websites for content and associations. Below, please provide the information we need (user name, email address, etc.) so that we can access and review your social media sites. Do not provide passwords.

If you do not wish to provide your information here, you must contact Deputy First Class Lisa Thomas at 770-781-2222 x-3150 or LAThomas@forsythco.com to make arrangements for his review of your social mediacontent and associations.

You will receive an email from Deputy Lisa Thomas, or her designee, informing you of impending friend or other access requests to any listed social media sites. Once the review has been concluded, the friend status or access granted will be deleted by Deputy Lisa Thomas or her designee.

Intentional omission of any social media site may disqualify your application.

Applicant's Email Address

Facebook

Linkedln

My Space

Twitter

Pinterest

BLOG

Other

Applicant's Printed Name

Applicant's Signature Date

Revlaed 01/08/15 FORSYTH COUNTY IS AN EQUAL OPPORTUNITY l!MPLOYER FORM#B