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  1. [Image of Police Badge
  2. Application for Police Officer

    Orono Police Department

    2730 Kelley Pkwy

    Orono, MN 55323

    (952) 249-4700

  3. Contact Information:
  4. Are you 18 years of age or over?*
  5. Are you legally eligible to work in the United States in the position for which you are applying? Proof of citizenship or work eligibility will be required as a condition of employment.
  6. Have you previously been employed by the City?
  7. Education:
  8. Did you graduate from high school or receive a GED?*
  9. Did You Graduate?
  10. Did You Graduate?
  11. Did You Graduate?
  12. Work Experience (Experience and training ratings are determined by this information. Please be complete.) List your present or most recent experience first. Attach additional sheets if necessary.
  13. Supervisor's Title
  14. May we contact your present employer?
  15. Supervisor's Title
  16. May we contact your present employer?
  17. Supervisor's Title
  18. May we contact your present employer?
  19. Supervisor's Title
  20. May we contact your present employer?
  21. Are you eligible to be POST licensed?
  22. The City of Orono will not discriminate against or harass any employee or applicant for employment because of race, color, creed, religion, national origin, sex, disability, marital status, or status with regard to public assistance.
  23. Job Relevant Volunteer and Unpaid Work Experience
  24. In accordance with the Immigration Reform and Control Act of 1986, the City of Orono hires only U.S. Citizens and lawfully authorized alien workers. If hired, you will be required to provide written documentation of citizenship or legalized alien program. Failure to provide said documentation will result in dismissal.
  25. MN Stat. Sec. 518.611, Subd. 8, requires employers to obtain information from all new employees regarding court-ordered child support obligations that are required by law to be withheld from income. Failure to provide said documentation will result in dismissal.
  26. Have you served a sentence in jail or prison or been convicted of a misdemeanor or felony for which a jail sentence could have been imposed?
  27. You may answer "No" if the conviction or criminal records have been annulled, sealed, set aside, or purged, or if you have been pardoned pursuant to the law.
  28. If you are hired for this position you may be required to undergo a physical examination at the City's expense to determine whether or not you are able to perform the duties of this position in an effective and safe manner, and whether or not accommodations need to be made for you.
  29. The City of Orono does not discriminate on the basis of handicapped status in the admission or access to, or treatment or employment in, its programs or activities. It is the policy of the City of Orono to provide reasonable accommodations to the known physical and mental limitations of qualified handicapped applicants and employees in order for them to perform the essential functions of the job in question.
  30. Did you serve in the military service of this country and separate under honorable conditions from any branch of the armed forces of the U.S. after having served on active duty for 181 consecutive days or by reason of disability incurred while serving on active duty?
  31. If "Yes", are you a permanent resident of the State of Minnesota?
  32. Give the names of three people outside of relatives who can be contacted regarding your qualifications, work habits, and character.
  33. The City of Orono is an EQUAL OPPORTUNITY EMPLOYER
  34. The City of Orono has the right to verify information provided in the application. False information may subject an applicant to the penalty provisions of M.S. 43A.39.
  35. In connection with this application for employment, I authorize the City of Orono and any agent acting on its behalf to conduct an inquiry into any job-related information contained in this application, including, but not limited to, my records maintained by an educational institution related to academic performance such as transcripts. Moreover, I hereby release the City of Orono and any agent acting on its behalf from any and all liability of whatsoever nature by reason of requesting such information from any person.
  36. Electronic Signature Agreement
    I declare that any statement in this application or information provided is true and complete and hereby acknowledge that I have read and understand the information below.
  37. IMPORTANT FACTS ABOUT INFORMATION ON YOUR APPLICATION This application is to assist in the process of referring you for possible employment. Certain information requested on the application is private, that is, may be released only to you or to agencies where you may be considered for employment (to comply with M.S. 15.165, Subd. 2). If you are employed, the data will be available to the Department of Finance, the Internal Revenue Service, and the Social Security Administration for payroll and tax purposes. If you disagree with the data we have about you, you may notify the City.
  38. Private Data
  39. Why we Ask for it
  40. Are You Legally Obligated to Provide it?
  41. What May Happen if you Don't Provide it?
  42. Social Security Number
  43. To distinguish you from all other applicants, and to make processing more efficient.
  44. No
  45. In most cases, nothing. However, it will help to ensure that we do not confuse your records with those of others.
  46. Date of Birth (Final applicants only)
  47. To conduct check of criminal record for certain positions
  48. No
  49. Failure to provide information may be cause for rejecting an applicant.
  50. Name (The names of finalists for a position are public information.)
  51. To distinguish you from all other applicants.
  52. Yes
  53. Failure to provide information may be cause for rejecting an applicant.
  54. Street Address (City and County of residence are public information.)
  55. To be able to contact you to determine availability for interview.
  56. No
  57. We may not be able to employ you in certain jobs where you may be required to come to work on short notice.
  58. Sex, Racial/Ethnic Group, Handicapped Status, Veteran Status
  59. To be able to make Equal Opportunity reports as required by law.
  60. No
  61. We will not be able to determine whether our selection processes result in discrimination, or to take affirmative action in our hiring.
  62. Conviction Record
  63. To determine whether we may legally accept an application from you and determine whether your record may be a job-related consideration.
  64. Yes
  65. We will not be able to make determinations required by law.
  66. All other information on the application is public, and may be given to anyone for any purpose.
  67. Leave This Blank:

  68. This field is not part of the form submission.