PPD 1

LATERAL POLICE OFFICER APPLICANTS

Thank you for your interest in a career with the Phoenix Police Department. Your name will remain on the eligibility list for one year from the date of certification provided by the City of Phoenix Human Resources Section. During your background process, you will be required to take and successfully pass the Police Physical Agility Test. Once your background packet is received, your assigned background detective will schedule a Physical Agility Test for you.

Attached to this memorandum is an Arizona Peace Officer Standards and Training Board (AzPost) Statement of Personal History and Application for Certification. Please read all of the instructions and guidelines first. It is the only packet that you will receive. We recommend you make a copy of the packet to use as a “rough draft” prior to completing the original copy. Your original completed copy will be submitted to the Employment Services Bureau. The packet must be typed or printed in black ink, legibly written and must contain all the information requested. You must answer all of the questions and supply any information that may be pertinent to your background process. If the question does not apply to you, write “DNA” (does not apply) in the space. If more room is needed, use the continuation sheet (page 9 of 10) to provide further explanation. The Police Employment Services Bureau staff will not accept the packet if it is not completed as instructed.

We realize your current employer might not be aware you are seeking other employment. If you do not want your current employer contacted by your background investigator during the beginning phase of your process, please place a note in pencil or post-it note next to the current employer box indicating you do not want your current employer contacted. The background investigator will not contact your current employer until the end of your process.

Two color passport photographs in business attire must be attached to your packet at the time it is submitted to the Employment Services Bureau. No computerized photographs, large photographs or self-taken photographs will be accepted. Utilize a business that takes passport type photographs.

The completed packet can either be mailed back to the Employment Services Bureau or can be hand-carried to the Employment Services Bureau in the main police station located at 620 W. Washington. (Refer to Section D for mailing instructions). Once the packet is received it becomes the property of AzPOST and the Phoenix Police Department.

Thank you for pursuing a law enforcement career with the Phoenix Police Department.

PPD 2

BACKGROUND PACKET INSTRUCTIONS

The ability to read and follow directions, as well as the proper completion of paperwork, are major

functions of a Police Officer; therefore, you are expected to complete this packet with the information that is

contained in these instructions. If you have a question, please read through the entire packet first.

Suggestion: Make a copy of the blank forms when you receive them and use that copy as a “rough draft.”

Make all your corrections on the copy and when you feel the packet is complete, fill out the original forms.

This will eliminate a messy packet and speed up the process. If it is not legible, it will be returned. Hold onto

these instruction sheets (Pages PPD-1 thru PPD-5) for future reference; do not turn them in to the

Employment Services Bureau with your Arizona POST Statement of Personal History.

Please be as accurate as possible on all forms. Any questions or clarifications will be addressed during the

interview process.

A. The following forms are included:

1. Arizona Peace Officer Standards and Training Board (POST) Statement of Personal History

(Pages 1 – 10)

2. Confidential Information Agreement Form (PPD-1B)

B. Completion of forms: FORMS MUST BE TYPED OR PRINTED IN BLACK

INK ONLY.

1. Arizona POST Statement of Personal History.

a. Follow the instructions included in this packet very carefully. Each section is explained in detail.

b. Authorization For Release of Information form (page 2 of 10): Read carefully and complete all blanks. This form must be notarized prior to submitting to the Employment Services Bureau.

2. Employment History

a. List all places you have worked, including city, state, and zip codes.

b. Use continuation sheet (pg 9 of 10) if necessary.

3. Driving History

a. List all citations you have received.

b. Include those that were dismissed, found not guilty, or attended traffic school.

4. Drug Use Questionnaire

a. Complete every box and/or blank truthfully and accurately.

b. Dates – list month and year as closely as possible.

c. Number of times used – write one number only! DO NOT GIVE A RANGE OF NUMBERS.

d. Read each question carefully.

e. If you feel the need to make an explanation, do so on the continuation sheet (pg 9 of 10). Give the item number, print (do not type), and include this sheet with the other forms.

5. Supplemental/Separate Sheets

a. Use only photocopies of continuation sheet (pg 9 of 10).

b. Print name and social security number at the top of each page.

PPD 3

6. Confidential Information Agreement Form

a. Must be notarized prior to submitting packet.

C. Obtain two (2) color passport type photographs in business attire and attach to the completed packet.

No other type of photograph will be accepted.

D. When completed, return background packet, along with the photographs, to:

Phoenix Police Department

Employment Services Bureau

620 West Washington Street, Room #107

Phoenix, Arizona 85003

Phone (602)262-6925

Hours: Monday through Thursday 7:00 a.m. – 5:00 p.m. Friday 7:00 a.m. – 4:30 p.m.

Out of state applicants – This statement of personal history and photos may be mailed to the above listed

address. The City of Phoenix does not take responsibility for items not delivered to our office. Therefore, we

suggest you use registered mail to ensure the forms are delivered. Incomplete or inaccurate forms will not be

processed.

E. At the time of your interview, you will be required to produce your original documents and a

photocopy. Do not mail these documents, rather bring them with you to your interview. If you do

not have one of the required documents, take the appropriate steps NOW to obtain it:

1. Certified (Department of Health) birth certificate. No other item will be accepted, including the

hospital issued certificates

2. High school diploma or GED certificate (not required if you have a Bachelor or Masters Degree)

3. College degree or transcripts if no degree was achieved

4. Social security card (2 copies)

5. Driver’s license

6. DD 214-form 4 military discharge (the Member 4 form is the only form we will accept)

7. Marriage license

8. Divorce decree

9. Bankruptcy petition/discharge

10. Last two (2) job performance evaluations, if your employer gives you one

11. Proof of current auto insurance (the insurance card will do)

12. AZ POST Academy Certificate

13. In-service training certificates

14. Out of State Laterals Only - Syllabus from your specific academy class

15. Current Résumé

16. Vehicle Registration

You must bring to the interview the original and one photocopy of the above documents. If you have

multiple marriages and divorces, bring the marriage license and divorce decree for each. If you had your name

changed for any reason, include the necessary documents with the above.

The Phoenix Police Department will process files as quickly as possible. We encourage all candidates to return

their packets as soon as possible. Thank you for pursuing a career with the City of Phoenix Police Department.

PPD 4

FORMS MUST BE TYPED OR PRINTED IN BLACK INK ONLY.

PEACE OFFICER CODE OF ETHICS – (Page 1 of 10)

This code must be read, signed, and dated by you, stating that you will abide by the code.

AUTHORIZATION FOR RELEASE OF INFORMATION FORM – (Page 2 of 10) This form must be notarized prior to submitting packet to Police Employment Services Bureau.

CONFIDENTIAL INFORMATION AGREEMENT FORM – (Page – PPD-1B)

This form must be notarized prior to submitting packet to Police Employment Services Bureau.

FORMS MUST BE TYPED OR PRINTED IN BLACK INK ONLY. 1. Print full name beginning with last name first. Need full middle name.

2. Current address required. Do not use PO Box as an address. Include apartment number, etc.

3. City you reside in.

4. State and zip code.

5. Date of birth. Begin with month written out followed by day and year. (Example, July 3, 1975).

6. Place of birth. Include city and state.

7. Social security number.

8. Include maiden name, former marriage names, birth names, etc.

9. Single, divorced, married, or legal separation.

10. If married, list spouse’s maiden name.

11. Include area codes.

12. Include area code and any extensions. Please give a work number where you can be reached.

13. Include area codes.

14. If not citizen, explain on continuation sheet. Proof of citizenship will be required before hire.

15. Check either GED or high school diploma. Proof will be required.

16. List year and high school graduated from, along with city and state where certificate received.

17. If you have been in the military service, check yes and complete remaining section.

18. List at least 3 people who have known you for over one year. Do not use relatives, present or former

employers, or current Phoenix police officers. Please include full addresses including zip codes and

area codes. *Phoenix police officers will be contacted by your background investigator after your

interview using a different form provided to the officer.

PPD 5

19. If you recently served in the military it is not necessary to include members who shared the same

barracks. Include full addresses, zip codes, and area codes. This does include college roommates.

20. Include full addresses, zip codes, and area codes. Include step family information.

21. List all jobs you have worked throughout your lifetime beginning with most recent. Use full addresses

including zip codes. List supervisors’ name and phone numbers, including area codes, job title, and job

duties, and reason for leaving, i.e. school, better paying job, fired, etc. Use continuation sheet if

necessary. Please list all periods of unemployment over 30 days.

22. Full name of college including city and state. List all degrees you have received or total of college

credits earned. If you are working toward a degree but have not yet received a degree, only list credits

obtained. Proof of a degree will be required along with college transcripts.

23. List all in the past five years.

24. If you received a citation in lieu of detention (ticket), this is considered an arrest. If a case was

dismissed, the arrest must still be included. Please explain all incidents on the continuation sheet. This

includes all adult and juvenile arrests. *Juvenile arrests are not sealed at age 18.

25. This includes divorce, order of protection, injunction prohibiting harassment, and lawsuits of any kind.

26. Complete as listed.

27. Include state and license number.

28. If box marked yes, an explanation must be included on the continuation sheet. This explanation should

include reason for suspension or revocation, date of suspension/revocation and date of reinstatement.

29. List all violations you have been cited for throughout your lifetime except for parking violations and

warnings. If you received more than one violation during a traffic stop, all must be listed. Most motor

vehicle printouts obtained through the MVD office will only show last 3 to 5 years. We need all

citations ever received. List the court dispositions (example: fines, traffic school, dismissed, etc.).

30. It is important that each box is completed. If it does not apply, put DNA. Do not give range of

numbers, i.e. 3 to 10.

31. If applicable, follow instructions A thru F.

32. Mark as applicable.

33. If marked yes, a full explanation must be included on the continuation sheet.

34. Mark as applicable.

35. Mark as applicable.

36. List complete name of agency and state.

37. Please sign your name legibly.

Map7056\G:\OPERATIONS UNIT\Templates & Forms\Background Investigation\Sworn Packet Instructions\LateralBackgroundPacketInstructions062117.docx

To: Police Applicants

From: Operations Unit Police Employment Services Bureau

Subject: INTERVIEW SCHEDULE AND ADDITIONAL INFORMATION

Please turn in this form with your background packet. In order to expedite the scheduling of your initial interview with a Background Investigator, I request that you take a few minutes to fill out the information below. Continue to gather the required documents requested and bring them with you to your interview.

___ ____ ___________ Last Name First Name Middle Name (full)

________________________________ _________________ Social Security Number Date of Birth

_____ __ Current Employment work hours Days off Work phone

__________________________ Home Phone Cellular Phone E-mail Address

Have you done any volunteer work? Yes _____ No _____ If Yes, please list the organization and/or information pertaining to the volunteer work _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

Do you speak a foreign language? (sign language included) Yes _____ No _____ If Yes, please list the language/s that you speak _______________ Fluently? Yes _____ No_____

_______________ Fluently? Yes _____ No_____ _______________ Fluently? Yes _____ No_____

G:\OPERATIONS UNIT\Templates & Forms\Background Investigation\Sworn Packet Instructions\INTRVWDT.DOC

LATERAL

PPD 1A

CONFIDENTIAL INFORMATION AGREEMENT FORM

A thorough investigation will be conducted to determine your qualifications for employment with the Phoenix Police Department. To a great extent, your employment will depend on information obtained in confidential interviews with persons with whom you have been associated and other confidential sources of information. Therefore, such information shall remain confidential, and the Phoenix Police Department cannot reveal the reason of rejection for those applicants who are not accepted.

If the reasons for your non-acceptance are of a temporary nature whereby you could be accepted at a later date, you will be so notified.

I, ____________________________________________, hereby waive any and all claims of confidentiality against anyone who may have knowledge of my fitness for employment with the Phoenix Police Department.

For and in consideration of the Phoenix Police Department’s acceptance and processing of my application for employment I, ______________________________________________, agree to hold the City of Phoenix, its agents and employees harmless from any and all claims and liability associated with my application for employment or in any way connected with the decision whether or not to employ me with the Phoenix Police Department. I understand that should information of a serious criminal nature surface as a result of this investigation; such information may be turned over to the proper authorities.

______________________________________ Signature of Applicant

_________________ Date

STATE OF___________________, COUNTY OF _______________

Subscribed and sworn before me, This _______ day of_______________, 2_____.

___________________________Notary Public

G:\OPERATIONS UNIT\Templates & Forms\Background Investigation\Sworn Packet Instructions\Confidential Agreement Form.doc

PPD 1B

Arizona Peace Officer Standards and Training Board

November 8

Arizona Peace Officer Standards and Training Board

November 8

Arizona Peace Officer Standards and Training Board

et seq.

November 8

November 8

November 8

November 2018

not

November 2018

If Yes to either 32a or 32b, provide a full explanation on the Continuation Sheet.

November 2018

Arizona Peace Officer Standards and Training Board

November 2018

Applicant Name: ____________________________ Agency: ____________________________________

AGENCY VERIFICATON OF APPLICANTS

QUALIFICATIONS AND DOCUMENTATIONPlease initial

Page 1 Code of Ethics read, signed and dated. Page 2 Authorization for Release of Information fully completed and notarized. Page 3 Agency Verification completed and results documented in file. Page 4 Agency Verification completed and results documented in file. Page 5 Agency Verification completed and results documented in file. Page 6 Agency Verification completed and results documented in file. Page 7 Agency Verification completed and results documented in file. Page 8 Agency Verification completed and results documented in file. In-Person Review of AZPOST PH with Applicant to confirm information Lateral Applicants – Prior Agency personnel file reviewed for past performance and/or prior misconduct Applicant has applied with other agencies – inquiry completed with agency to determine status and/or disqualifiers identified. Inconsistent information from applicant during background process, including polygraph, corrected by applicant on AZPOST PH form. Applicant meets minimum qualifications and documentation is complete and in file. Applicant does not meet minimum qualifications. Application Process TerminatedReason for Disqualification:

Medical Examination completed and in file and applicant meets standards. Medical Examination completed and in file and applicant does not meet standards ME and MH forms properly completed and in file. F.B.I./D.P.S. record checks completed and in file. F.B.I./D.P.S. record checks completed and in file and reflects arrest record. F.B.I./D.P.S. record checks has been submitted, no return yet. NCIC/III/ACIC/ACCH records check completed and in file and no record found. NCIC/III/ACIC/ACCH records check completed and in file and record found. Polygraph completed and report in file and applicant passed Polygraph completed and report in file and applicant failed. Applicant does not meet all requirements. Application Process TerminatedReason for Disqualification:

AGENCY CERTIFICATION:

I hereby certify that I have reviewed this application for completeness and the required documentation in accordance with R13-4-106(C)(7) and hereby attest that this person meets minimum qualifications for appointment, has not engaged in conduct or a pattern of conduct that would jeopardize public trust in the law enforcement profession, is of good moral character and have completed this report to document that finding.

NAME OF REVIEWER: ________________________________________ TITLE: ______________________________________

SIGNATURE OF REVIEWER: ______________________________________ DATE: ______________________________

AZ POST Form PH (November 2018) Page 10 of 10