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Short Term Volunteer Application

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This form has been modified since it was saved. Please review all fields before submitting.

Steps

1. Position This section is complete This section is incomplete
2. Personal Information This section is complete This section is incomplete
3. Employment Information This section is complete This section is incomplete
4. References This section is complete This section is incomplete
5. Position Information This section is complete This section is incomplete
6. Supplemental Application This section is complete This section is incomplete

Position

Volunteers Assisting Pueblo Police
All volunteers must be at least 18 years or older to submit an application
POSITION: Short Term Volunteer
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Personal Information

First Name*
Middle
Last Name*
Date of Birth*
Social Security Number*
Nickname(s)
Maiden Name
Married Name(s)
Address1*
City*
State*
Zip*
Home Phone*
Work Phone
Mobile Phone
Email Address*
In case of emergency, whom should we contact?
Name
Relationship
Address
Zip
Home Phone
Work Phone
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Employment Information

Current Employer
Employers Address
City
Zip
Describe your duties on your current or most recent job(s)
Describe previous work experience
List special skills, training, foreign languages, or computer skills you possess
Do you have any interests or hobbies we may utilize?
Please list any previous or present volunteer experiences
List community affiliations (clubs, organizations, church)
Upload Current Resume (optional)
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References

Please list three professional references.
Full Name
Relationship
Company
May we contact them by Email and/or Phone?
1. Email
1. Phone
Email Address
Phone Number
Full Name
Relationship
Company
Phone Number
Email Address
May we contact them by Email and/or Phone?
1. Email
1. Phone
Full Name
Relationship
Company
May we contact them by Email and/or Phone?
1. Email
1. Phone
Email Address
Phone Number
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Position Information

It is a normal part of the Pueblo Police Volunteer Program procedure to perform checks (record and reference) on the suitability of new personnel due to the nature and sensitivity of the work. This standard is equally applicable to volunteers in that voluntary staff is treated with the same seriousness and consideration given professionals. Also, the successful completion of a polygraph examination is a qualification to work in certain units or program. If accepted, I agree to adhere to the policies and procedures of the Pueblo Police Volunteer Program and the City of Pueblo which include the confidentiality of information.
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box, I certify that my answers are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that if hired I may be released from employment.

I understand that the company may require me to successfully complete a pre-employment drug and alcohol test and a background check as a condition of employment and that continued employment may be based on the successful completion of similar tests.
Applicant Signature*
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Supplemental Application

Supplemental Application
First Name
Last Name
DOB
1. Are you or were you ever P.O.S.T. Certified?
1. NO
1. YES
(if yes, provide details of when, along with P.O.S.T.#)
2. Do you have at least 60 semester hours or 90 quarter hours from an accredited college or university?
1. NO
1. YES
3. Have you ever served in the Military?
1. NO
1. YES
(if so please provide branch and time frames of service and include discharge status if applicable)
4. You MUST have a valid Colorado Driver’s License to apply
1. NO
1. YES
Driver's License
Number
Attach scanned copy (if unable to scan, bring your DL in when called)
5. Has your driver’s license in any state ever been surrendered, denied, revoked, suspended, restricted or placed on probation?
1. NO
1. YES
(if so provide details)
6. Have you ever been arrested for operating a motor vehicle while impaired or under the influence of drugs and or alcohol?
1. NO
1. YES
(if so provide the date(s) and outcome)
7. Are you now or have you ever been the subject of a restraining order?
1. NO
1. YES
(if so give details)
8. Are you now, or have you ever been a member or associate of a criminal enterprise, street gang, or any other group that advocates violence against individuals because of their race, religion, political affiliation, ethnic origin, nationality, gender, sexual preference, or disability?
1. NO
1. YES
(if so please give details)
9. Have you EVER committed any crime involving a sex offense?
1. NO
1. YES
(if so please provide details)
10. Have you ever been terminated or asked to resign from any employer?
1. NO
1. YES
(if so please provide details)
11. Have you ever taken anything, including money and merchandise, from a place where you worked without permission?
1. NO
1. YES
(if so give details)
12. Have you EVER been charged/convicted of a misdemeanor criminal offense?
1. NO
1. YES
(if yes, provide dates and conviction terms)
13. Have you EVER been charged/convicted of a felony criminal offense?
1. NO
1. YES
(if yes, provide dates and conviction terms)
14. Have you ever committed any offenses, including but not limited to: (check all that apply)
1. Harassment
2. Robbery
3. Arson
4. Burglary
5. Trespassing
1. Auto Theft
2. Disorderly Conduct
3. Forgery / Fraud
4. Assault
5. Theft
1. Restraining Order Violation
2. Criminal Mischief
3. Child Abuse
4. Domestic Violence
5. Sexual Assault
Other (please provide details)
15. This section covers any drugs, including unauthorized use of prescription drugs. Your answer should include, but not be limited to your use of any of the following drugs: (check all that apply)
1. Methamphetamines/ Amphetamines
2. Barbiturates or “downers”
3. Designer Drugs (Ecstasy, etc .. )
4. Cocaine/Crack Cocaine
5. GHB or “Date Rape Drug”
1. Hallucinogens
2. Marijuana
3. Morphine
4. Quaalude's
5. Heroin/Opium
1. Mescaline
2. Hashish/Hashish Oil
3. Steroids
4. THC
5. Glue
16. Do you now or have you EVER illegally used, tried or experimented with any substance listed above?
1. NO
1. YES
(if so please provide details)
17. Have you ever intentionally ingested a toxic substance to become intoxicated?
1. NO
1. YES
(if so please provide details)
18. Have you EVER obtained a prescription medication or controlled substance fraudulently or by forging a prescription order, or used a prescription drug belonging to someone else?
1. NO
1. YES
(if so please provide details)
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box, I certify that the information in this application, supplement, and any attachments are true and complete to the best of my knowledge. I understand and agree that any false information, misrepresentations, omissions, or misleading statements may subject me to disqualification and rejection of this application. I understand that it is my responsibility to keep the City of Pueblo informed of changes in my application, including address, phone number, employment, availability, etc.
Signature
Date

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