Mills Police Department Online Application
INSTRUCTIONS: Answer all of the questions. If something does not apply, put N/A. After you have finished filling out the form, copy the form and then paste it into an email. Email to kpike@millspd.org. When a position becomes available, we may contact you for further information & documentation. By submitting this form you are certifying that the answers given herein are true and complete to the best of your knowledge; and you authorize the investigation of all statements contained in this application as may be necessary in arriving at an employment decision.
The Town of Mills considers applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. Thank you for your interest in the Mills Police Department.
First Name: Middle Name: Last Name:
Date of Birth: Phone Number:
Physical Address: City: State: Zip:
Mailing Address: City: State: Zip:
Do you have a relative employed by the Town of Mills: If yes, whom:
Have you been convicted of a felony?
Have you been convicted or a crime that excludes you from carrying a firearm?
Do You Have a High School Diploma or Equivalent?
Any Prior Law Enforcement Experience? Years:
Any Military Experience? Branch of Service: Type of Discharge:
College Education? Years:
Is there any reason you cannot perform the functions of the position for which you are applying?
Current or Last
Address:
Duties & Responsibilities:
Reason for Leaving:
If presently employed, may we contact above?
Previous 1
Previous 2
Driver's License Number:
Has your driver's license ever been suspended or revoked?
List any accidents or moving violations incurred during the past 36 months.
Date (mm/dd/yyyy)
I understand that my insurability will be verified and I may not be eligible for employment in a driving essential position or, if employed, I may be terminated because I am uninsurable.