APPLICANT ELIGIBILITY QUESTIONNAIRE INSTRUCTION SHEET
Option 1: Complete this form using Adobe Acrobat Reader or Adobe Acrobat and Submit Form. You can also complete the form, save it to your computer and email it as an attachment to [email protected].
Viewers such as Apple Preview and Google Chrome PDF Viewer may not allow you to submit the form electronically. You can obtain the Adobe PDF Reader by clicking here. Once installed you will be able to complete the form and use the Submit Form function.
Option 2: Complete the form, print it out and mail it to:
Corpus Christi Police Department Attention: Background Investigations P.O. Box 9016 Corpus Christi, TX 78469-9016
Option 3: Complete the form and submit it in person at:
Corpus Christi Police Department 5th Floor (turn in to receptionist's desk located at the end of the hall)
321 John Sartain Corpus Christi, TX 78401
If you have any questions please contact the Background Investigations section at 361.886.2626.
The City of Corpus Christi will not discriminate against any applicant or employee based on race, color, religion, sex, pregnancy, age, sexual orientation, gender identity, national origin, military status, citizenship, work related injury or illness, disability, or genetic information.
CORPUS CHRISTI POLICE DEPARTMENT Eligibility Questionnaire
Eligibility Questionnaire
YOUR CONTACT INFORMATION
First Name Last Name Middle Name
Date of Birth Social Security Number
Driver's License Number State Expiration Date
Mailing Address (Street, City, State, Zip Code) Apt. #
Phone Number E-mail Address
Are you a U. S. Citizen?
Yes No
Are you at least 21 years of age?
Yes No
Are you under 45 years of age?
Yes No
Did you graduate from high school with at least a 2.0 GPA?
Yes No
If you answered no to the previous question, do you have a GED with twelve (12) credit hours from an accredited college with at least a 2.0 GPA?
Yes No Not Applicable
Eligibility Questionnaire
Have you served on active duty for a minimum of one hundred and eighty (180) consecutive days in the United States Armed Forces?
Yes No
Have you been discharged from any military branch for receiving a dishonorable discharge or any other discharge based on misconduct?
Yes No
Have you ever been terminated from a job, quit prior to termination or asked to resign in-lieu of termination?
Yes No
Do you have two (2) or more moving violations in the past twelve (12) months?
Yes No
Have your driving privileges been suspended or revoked within the past twenty-four (24) months?
Yes No
Have you had a Driving While Intoxicated (DWI) conviction within the past ten (10) years?
Yes No
Have you ever been arrested, either as an adult or juvenile?
Yes No
Have you ever been convicted of any crime? Not to include traffic tickets/violations.
Yes No
Eligibility Questionnaire
Have you ever been placed on probation, received deferred adjudication or pre-trial diversion for any offense?
Yes No
Have you ever been charged with a crime but later acquitted?
Yes No
Have you used any illegal drugs in the last twelve (12) months?
Yes No
Have you used any illegal drugs in the last twenty-four (24) months?
Yes No
Have you used any illegal drugs in the last thirty-six (36) months?
Yes No
Have you previously applied with our department for the position of Police Officer?
Yes No
If yes to the above question, list the most recent year you applied?
Eligibility Questionnaire - Survey
How did you learn about a career with the Corpus Christi Police Department?
Career Expo/Job Fair
Event/Location: _____________________________________________________
College Fair/Presentation
Event/Location: _____________________________________________________
Current or Retired City Employee Referral
Email Notification
Facebook (Corpus Christi Police Department page)
Indeed
Military Job Fair Newspaper/Magazine Publication
Police One
Radio Station Advertisement
CCPD Recruiter/CCPD Sworn Officer
Twitter (CCPD)
Other
List: _______________________________________________________________
Eligibility Questionnaire
ACKNOWLEDGEMENTS
I have reviewed this Eligibility Questionnaire for completeness and accuracy prior to submitting. I understand that if my application is incomplete, I will not be considered for the position.
I agree
I hereby certify that all statements made in this application are true and complete. I understand that any discrepancies, misstatements, omissions, and/or falsifications will be cause for my disqualification, and my name will be removed from the eligibility list or I will face immediate termination if an appointment has been made.
I agree
I do hereby authorize the release, review and full disclosure of all records concerning myself to the Corpus Christi Police Department, whether said records are of a public, private, or confidential nature. This release is valid for any individual, organization, department, business, or other body as deemed necessary by the Corpus Christi Police Department to determine my eligibility for employment with said department.
I agree
Completion Date
CLICK TO SUBMIT
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