Application – Patrol Officer (FT/PT/Reserve) Please enable JavaScript in your browser to complete this form. – Step 1 of 18Application Instructions Complete all applicable sections of this application. Answer each question fully and accurately. If a question does not apply, enter “N/A” where permitted. Information submitted in this application will be used during the initial selection process and may be verified. Applicants who advance in the selection process may be required to complete a separate, more detailed personal-history/background-investigation packet and provide additional records or authorizations. Material omissions, misrepresentations, or false statements may result in disqualification from the selection process or, if employed, disciplinary action up to and including termination. Required or requested supporting documents may be uploaded where indicated. Do not submit original documents. Applicants requiring a reasonable accommodation during the application or selection process may contact the Mar-Mac Police Department at (563) 873-2500. Acknowledgment of Instructions *I have read and understand the application instructions.Position Selection and Applicant InformationSelect each position for which you wish to be considered, then provide your contact information and answer the eligibility questions. Age requirements apply at the time of appointment. Questions may vary based on the positions selected.Position(s) for Which You Wish to Be Considered *Full-Time Police OfficerCertified Part-Time Police OfficerReserve Police OfficerSelect each position for which you wish to be considered, then provide your contact information and answer the eligibility questions. Age requirements apply at the time of appointment. Questions may vary based on the positions selected.Full Legal Name *FirstMiddleLastCurrent Mailing Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePreferred Phone Number *Applicant Email Address *Will you be at least 21 years of age at the time of appointment? *YesNoWill you be at least 18 years of age at the time of appointment? *YesNoDo you currently possess a valid driver’s license? *YesNoSelect issuing stateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDriver's License Number *Date of Birth *Have you previously applied for employment with the Mar-Mac Police Department or Mar-Mac Unified Law Enforcement District? *YesNoAre you a citizen of the United States? *YesNo the an ever NextPage 2 — Minimum QualificationsPosition-Specific Minimum QualificationsAnswer the questions applicable to each position you selected. Requirements differ among full-time, certified part-time, and reserve positions. Your responses will be reviewed with the education, certification, and employment information provided later in this application.Which of the following education or experience qualifications do you meet for the Full-Time Police Officer position? *I possess an associate degree or higherI have earned at least 60 college creditsI have served as a certified law enforcement officer within the 180 days preceding the anticipated date of appointmentI have at least four years of service in the United States Armed ForcesNone of the aboveSelect all that apply. Select “None of the above” only if no other option applies. Recent certified service is measured against the anticipated appointment date.Do you currently hold regular Iowa peace-officer certification issued by the Iowa Law Enforcement Academy? *YesNoIowa reserve peace-officer certification and certification issued by another state do not, by themselves, satisfy this requirement for the District’s Certified Part-Time Police Officer position.Have you served as an Iowa law-enforcement officer within the previous 180 days? *YesNoUnsureThe District’s Certified Part-Time Police Officer position requires qualifying Iowa law-enforcement service within the 180 days preceding appointment. Eligibility will be verified against the anticipated appointment date.Which option best describes your Iowa reserve peace-officer certification status? *Currently certified as an Iowa Reserve Peace OfficerPreviously held Iowa Reserve Peace Officer certificationNot currently certified as an Iowa Reserve Peace OfficerCurrently hold regular Iowa law-enforcement officer certificationOther / UnsureSelect the option that best describes your status. Required training and certification will be evaluated for the reserve position.NextPage 3 — EducationEducationProvide information about your high-school education or equivalent credential and any post-secondary education. Include completed programs, current enrollment, and coursework that did not result in a degree.Do you possess a high-school diploma, GED, or other high-school equivalency credential recognized under applicable Iowa Law Enforcement Academy standards? *YesNoSchool or Credential-Issuing Institution *City and State or Country *Year Completed *Credential Earned *High School DiplomaGED / High School EquivalencyOther qualifying credentialCollege, University, and Technical EducationList each college, university, technical school, or trade school you have attended, beginning with the most recent. Include current enrollment and attendance that did not result in a degree. List law-enforcement academy certification in the certification section.Have you ever attended, or are you currently attending, a college, university, technical school, or trade school? *YesNoWhat is the highest post-secondary degree you have earned?No post-secondary degreeAssociate degreeBachelor’s degreeMaster’s degreeDoctoral / professional degreeOther Post-Secondary Institution Currently Attending This Institution? *YesNoInstitution Name *City / State or Country *Dates Attended *Enter MM/YYYY–MM/YYYY. If currently attending, enter ‘Present’ as the ending date.Major / Field of Study *If no major or program was declared, enter ‘Undeclared’ or ‘General Studies.’Credits or Training Hours Completed *Identify the amount and unit, such as 45 semester credits, 60 quarter credits, or 900 clock hours. Enter 0 if none have been completed.Degree, Credential, or Completion StatusCoursework only—no degree or credential earnedDegree or credential in progressCertificate / diploma earnedAssociate degree earnedBachelor’s degree earnedMaster’s degree earnedDoctoral / professional degree earnedOther Add Institution Remove Institution NextPage 4 — Law Enforcement CertificationLaw Enforcement CertificationIdentify any current or previous law-enforcement or reserve peace-officer certifications. Include certifications issued by Iowa and other states. If you have never held a certification, select the applicable response. List agency employment separately in the Employment History section.Which option best describes your Iowa peace-officer certification history? *Currently hold regular Iowa peace-officer certification.Previously held regular Iowa peace-officer certification.Previously certified as an Iowa Law Enforcement OfficerPreviously held Iowa reserve peace-officer certification only.Have never held Iowa peace-officer certification.Unsure of my Iowa certification status.If you have held both regular and reserve certifications, select the regular peace-officer option. Current employment and certification status are separate questions.Iowa Certification or Academy Completion Date *Provide the date for the certification identified above. Enter MM/YYYY if the exact date is unknown, or “Unknown” if you cannot provide an approximate date.Are you currently serving with an Iowa law-enforcement agency in a sworn capacity? *YesNoEnter MM/YYYY or “Never served.” Identify whether your most recent service was as a regular peace officer or reserve peace officer.Date Last Served in an Iowa Sworn Law-Enforcement Position *Enter MM/YYYY or “Never served.” Identify whether your most recent service was as a regular peace officer or reserve peace officer.Have you ever held held law-enforcement or reserve peace-officer certification issued by a state other than Iowa? *YesNo Out-of-State Certification Add a separate entry for each state and certification type. Report the status assigned by the issuing authority. An out-of-state credential does not itself establish Iowa certification.State or Jurisdiction *Identify the issuing state or jurisdiction.Certifying Authority *Name the licensing or certification authority.Certification Type *Regular peace officer / Reserve peace officer / OtherCertification or Academy Completion Date *Enter MM/YYYY or ‘Unknown.’Current Credential StatusActiveInactiveExpired or lapsedSuspendedRevokedSurrenderedUnsureOtherCertification NumberIf known.Additional Certification InformationClarify the credential type or status if needed. Detailed circumstances may be requested during the background investigation. Add Remove NextPage 5 — Military Service and Veterans’ PreferenceMilitary Service and Veterans’ PreferenceIdentify any service in the United States Armed Forces and indicate whether you are claiming veterans’ preference. Applicants without military service may answer “No” to the applicable questions. Additional service records may be requested during the selection process.Have you ever served, or are you currently serving, in the United States Armed Forces, including a Reserve component or the National Guard? *YesNo Military Service Record Add an entry for each branch or separate period of service. Include the component, such as active duty, Reserve, or National Guard. Use approximate month and year when exact dates are unavailable.Branch and Component *Service Status *Currently servingSeparatedRetiredService End Date *Date Separated / Ended *Enter MM/YYYY, or ‘Present’ if currently serving. Add Remove Character of Service / Discharge *HonorableGeneral Under Honorable ConditionsOther Than HonorableEntry-Level / UncharacterizedCurrently Serving / Not ApplicablePrefer to provide during background reviewOtherHave you completed at least four years of service in the United States Armed Forces? *YesNoFour years of armed service is one of the education or experience alternatives listed in the District’s Full-Time Police Officer job description. Report your service accurately; the District will verify whether it satisfies the applicable requirement.Are you claiming veterans’ preference under Iowa Code chapter 35C? *YesNoUnsure—please provide information about eligibilityIf you select “Yes” or “Unsure,” the District will provide instructions for establishing eligibility and submitting any required documentation. Selecting “Yes” does not, by itself, establish eligibility.NextPage 6 — Employment HistorySworn Law Enforcement EmploymentInclude all full-time, part-time, reserve, and volunteer sworn service, regardless of when it occurred. List each agency separately.Have you ever served with a law-enforcement agency in a sworn capacity, including full-time, part-time, reserve, or volunteer service? *YesNoHave you ever served with a law enforcement agency in a sworn capacity, including full-time, part-time, reserve, or volunteer service? Law Enforcement Agency Agency Name *Agency Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeService Classification *Full-timePart-timeReserveOther sworn serviceOtherCurrently Serving With This Agency? *YesNoStart Date *Enter MM/YYYYEnd Date *Enter MM/YYYY, or ‘Present’ if currently serving.Position or Highest Rank Held *Supervisor or Agency Head *If unknown or unavailable, enter ‘Unknown’ and briefly explain.Agency Phone Number *Agency or Supervisor EmailPrimary Duties *Reason for Leaving *If currently serving, enter ‘Currently employed’ or ‘Currently serving.’ If separated, briefly state the reason. Add Agency Remove Agency Other EmploymentList paid employment during the preceding ten years that you have not already identified above. Include self-employment and military employment. You do not need to list unpaid community activities in this section.During the preceding ten years, have you held any paid employment other than the sworn law-enforcement service listed above? *YesNo Employer or Self-Employment Begin with your most recent employment. For self-employment, identify your business or type of work and enter “Self-employed” where supervisor information does not apply.Employer or Business Name *Employer AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCurrently Employed Here? *YesNoStart Date *End Date *Position or Job Title *Supervisor *Employer Phone Number *Supervisor EmailPrimary Duties *Reason for Leaving * Add Employer Remove Employer During the preceding ten years, have you had any period of 30 consecutive days or longer that is not accounted for by the employment or military service listed? *YesNoInclude periods spent attending school, providing care, seeking employment, or otherwise not employed. Do not provide diagnoses, treatment information, or other medical details.Dates and Brief Explanation of Employment Gaps. *Identify the approximate dates and briefly explain each period of unemployment lasting 30 consecutive days or longer.May the District contact your current employer or employers during the initial selection process? *Yes, please contact me before reaching out to my current employer.No, do not contact my current employer at this stage.I am not currently employed, so no contact is necessary.Please contact me first before contacting any employer.I prefer not to be contacted regarding employment at this moment.A request to delay contact will not, by itself, disqualify you. Applicants advancing to a background investigation may be required to authorize employment verification. If your preference differs among current employers, explain below.NextPage 7 — Residential HistoryResidential HistoryList every residence where you have lived during the preceding ten years, beginning with your current residence. Include temporary residences, military housing, and school housing. Account for the entire period and explain any overlapping dates or periods without a fixed address. Use approximate month and year when exact dates are unavailable. Residence Residence Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeFrom *Enter MM/YYYYTo *Enter MM/YYYY, or ‘Present’ for your current residence.Housing Arrangement *OwnedRentedLived with family or friendsMilitary or other government housingSchool or university housingTemporary housing / no fixed addressOtherLandlord, Property Manager, or Housing ContactTelephone NumberProvide an available contact who can verify this residence, if applicable. Leave these contact fields blank if you owned the residence or no contact is available.Housing Contact EmailHousing Contact Phone NumberResidence Explanation or Additional Address InformationExplain overlapping dates, temporary housing, a period without a fixed address, or address details that do not fit the fields above. If no street address existed, enter “No fixed address” in Address Line 1 and identify the city and state or country. Add Residence Remove Residence I have provided my residential history for the preceding ten years to the best of my knowledge and have explained any gaps, overlapping dates, or periods without a fixed address. *I acknowledge.NextPage 8 — Financial InformationFinancial ResponsibilityAnswer the following questions about financial obligations for which you are personally responsible. A financial difficulty does not automatically disqualify you. Provide relevant circumstances, including disputed obligations and efforts to resolve delinquent accounts. Do not provide account numbers, Social Security numbers, medical details, or another person’s financial information.Are you currently delinquent on any financial obligation for which you are personally responsible? *YesNoUnsureIdentify the general type of obligation, approximate amount past due, and any dispute, payment arrangement, or other resolution efforts. If unsure whether an obligation is delinquent, explain why. *During the preceding seven years, have any financial obligations for which you were personally responsible been referred to a collection agency or charged off as uncollectible? *YesNoUnsureIdentify the general type of obligation, approximate date, and current status. Explain any dispute or resolution. Do not repeat details already provided; identify the earlier response instead. *During the preceding seven years, have you had property repossessed or voluntarily surrendered because you could not meet the payment obligation? *YesNoIdentify the general type of property, approximate date, circumstances, and current status of any remaining obligation. *Are you currently delinquent on any court-ordered financial obligation for which you are personally responsible? *YesNoUnsureIdentify the general nature of the obligation, approximate amount past due, and any dispute, payment arrangement, or resolution efforts. Do not identify children, former spouses, or other private individuals by name. *NextPage 9 — Criminal and Driving HistoryCriminal and Driving HistoryAnswer each question within its stated scope and reporting period. Provide approximate dates when exact dates are unavailable, and identify pending matters as pending. Do not report routine contacts solely as a victim, witness, or person requesting assistance. If a matter has already been disclosed, identify that response rather than repeating the details.Traffic Citations and OffensesDuring the preceding five years, have you received a traffic citation or been charged with a traffic offense, regardless of the final disposition? *YesNoInclude pending matters. Do not include parking tickets or written warnings in this section. Traffic Citation or Offense Approximate Date *Offense or Citation *Issuing Agency *City or County *State or Jurisdiction *— Select Choice —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDisposition *ConvictedDismissedAcquitted or found not guiltyDeferred or alternative dispositionPendingUnknownOtherAdditional Explanation Add Remove During the preceding five years, has your driver’s license or driving privilege been suspended, revoked, barred, canceled, or otherwise withdrawn in any state or jurisdiction? *YesNoUnsureInclude administrative actions and actions imposed by a court. Do not report an ordinary expiration or voluntary replacement of a license unless your driving privilege was also withdrawn.Identify the approximate date, state or jurisdiction, reason for the action, and whether your driving privilege has been restored. *Adult Criminal HistoryReport adult criminal matters responsive to the question below. Address juvenile matters only in the separate juvenile section. If a matter was reported in the traffic section, identify that entry rather than duplicating it.As an adult, have you ever been arrested, cited or summoned for a criminal offense, formally charged, convicted, entered a plea of guilty or no contest, or received a deferred judgment or similar disposition?YesNo Adult Criminal Matter Offense / Allegation *Approximate Date *Law Enforcement Agency *City *State *— Select Choice —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCourt / Jurisdiction *Final Disposition *ConvictedDismissedAcquitted/Not GuiltyDeferred Judgment/DispositionCharges Not FiledPendingOtherExplanation * Add Criminal Matter Remove Criminal Matter Juvenile Adjudication HistoryHave you ever been adjudicated delinquent as a juvenile for conduct that would have constituted a felony if committed by an adult? *YesNoUnsure Juvenile Adjudication Information Offense / Allegation *Approximate Date *State/Jurisdiction *Final Disposition *ConvictedDismissedAcquitted/Not GuiltyDeferred Judgment/DispositionCharges Not FiledPendingOtherExplanation * Add Juvenile Matter Remove Juvenile Matter Other Investigative ContactsOther than matters already disclosed, have you knowingly been the subject of a law-enforcement investigation into suspected criminal conduct? *YesNoUnsureDo not include contacts solely as a victim, witness, reporting person, or person requesting assistance. Report employment-related administrative investigations in the Employment Conduct section. Other Law-Enforcement Contacts Nature of Contact *Approximate Date *Agency *City/State *Disposition / Outcome *Explanation * Add Investigative Contact Remove Investigative Contact NextPage 10 — ReferencesPersonal ReferencesProvide five people who know you well enough to comment on your character, reliability, judgment, and interactions with others. Do not list relatives, current or former supervisors, or individuals already identified as employment-verification contacts. Select people who have had sufficient recent contact with you to provide meaningful information. Personal Reference List references you authorize the District to contact during the background investigation. Let each person know you have identified them as a reference and confirm that their contact information is current.Full Name *FirstLastOccupation or Current Role *Employer or Organization *How This Person Knows You *Length of Acquaintance *Preferred Phone Number *Email Address * Add Reference Remove Reference Personal Reference #2 List references you authorize the District to contact during the background investigation. Let each person know you have identified them as a reference and confirm that their contact information is current.Full Name *FirstLastOccupation or Current Role *Employer or Organization *How This Person Knows You *Length of Acquaintance *Preferred Phone Number *Email Address * Add Reference Remove Reference Personal Reference #3 List references you authorize the District to contact during the background investigation. Let each person know you have identified them as a reference and confirm that their contact information is current.Full Name *FirstLastOccupation or Current Role *Employer or Organization *How This Person Knows You *Length of Acquaintance *Preferred Phone Number *Email Address * Add Reference Remove Reference Personal Reference #4 List references you authorize the District to contact during the background investigation. Let each person know you have identified them as a reference and confirm that their contact information is current.Full Name *FirstLastOccupation or Current Role *Employer or Organization *How This Person Knows You *Length of Acquaintance *Preferred Phone Number *Email Address * Add Reference Remove Reference Personal Reference #5 List references you authorize the District to contact during the background investigation. Let each person know you have identified them as a reference and confirm that their contact information is current.Full Name *FirstLastOccupation or Current Role *Employer or Organization *How This Person Knows You *Length of Acquaintance *Preferred Phone Number *Email Address * Add Reference Remove Reference Authorization to Contact References *I authorize the Mar-Mac Unified Law Enforcement District to contact the references listed above for information relevant to my qualifications and suitability for the position.NextPage 11 — Employment Conduct and Professional HistoryEmployment Conduct and Professional HistoryAnswer the following questions about your employment and professional history. An affirmative response does not necessarily disqualify you. Include the circumstances, current status, and outcome of each matter. Identify allegations separately from findings. If you previously disclosed a matter, identify that response rather than repeating the details. Do not include confidential investigative records or medical information in your response.Have you ever received formal disciplinary action from an employer? *YesNoUnsureInclude written reprimands, disciplinary suspensions, demotions, disciplinary probation, or other formal disciplinary penalties. Do not include routine coaching, ordinary performance evaluations, or nondisciplinary counseling. Formal Disciplinary Action Employer or Agency *Approximate Date *Disciplinary Action Taken *Brief Circumstances *Current Status or Final Outcome *Identify whether the action remains in effect, was modified or overturned, or is under appeal.Additional Information * Add Disciplinary Action Remove Disciplinary Action Have you ever been terminated or discharged, asked to resign, resigned in lieu of termination or disciplinary action, or resigned while a formal disciplinary matter was pending? *YesNoInclude involuntary separations and explain whether they involved performance, conduct, a layoff, a position elimination, or another reason. Employment Separation Employer or Agency *Approximate Separation Date *Type of Separation *Terminated or dischargedAsked to resignResigned in lieu of termination or disciplineResigned while a disciplinary matter was pendingLayoff or position eliminationOtherCircumstances of Separation *Subsequent Review, Appeal, or Outcome * Add Separation Remove Separation During your law-enforcement service, have you ever been the subject of an internal affairs, professional standards, administrative, or other misconduct investigation? *YesNoInclude pending investigations and completed investigations regardless of the finding. Do not include matters in which you participated solely as a witness or investigator. Law Enforcement Administrative Investigation Agency *Approximate Date *Nature of Allegation *Investigation Status or Finding *— Select Choice —PendingSustainedNot SustainedUnfoundedExoneratedClosed without a findingOtherUnknownUse the agency’s terminology. Explain a different classification below.Discipline Imposed *Enter ‘None’ if no discipline was imposed, or ‘Pending’ if not yet determined.Brief Explanation * Add Remove Has any law-enforcement or reserve peace-officer certification you have held ever been suspended, revoked, surrendered, restricted, placed on probation, or made the subject of a decertification proceeding? *YesNoPending / UnsureInclude pending proceedings. Do not report an ordinary expiration or inactive status solely because you stopped serving unless it also involved an action identified above.Identify the state or certifying authority, approximate date, action or proceeding, circumstances, and current status or outcome. *Have you ever been notified by a prosecuting authority that information concerning your conduct may require disclosure as impeachment or credibility evidence in a criminal proceeding, sometimes referred to as Brady/Giglio information? *YesNoUnsureInclude a notification that was later withdrawn or resolved, and explain its outcome. Do not upload confidential case records.Identify the prosecuting authority, approximate notification date, general nature of the concern, and current status, including any review, withdrawal, or resolution. *NextPage 12 — Drug and Controlled-Substance HistoryDrug and Controlled-Substance HistoryAnswer the following questions about illegal drug use and controlled-substance conduct. Do not provide information about medical conditions, addiction diagnoses, counseling, rehabilitation, treatment, or lawfully prescribed medication. Provide approximate dates when exact dates are unavailable. The District will evaluate responses under applicable law and established hiring standards.Are you currently engaging in the illegal use of any drug or controlled substance? *YesNoInclude the use of prescription medication without a lawful prescription. Do not identify medication you take lawfully as prescribed.Identify the substance and approximate date of most recent use. If unsure, briefly explain the uncertainty without providing medical or treatment information. *Have you ever illegally used a drug or controlled substance, including prescription medication that was not prescribed to you? *YesNoDo not report lawful use of prescribed medication. Do not provide the frequency or quantity of past use, or information about addiction or treatment. Substance Use Information Substance *Approximate Date of Most Recent Use *Enter MM/YYYY, an approximate year, or “Unknown.”Additional Nonmedical Clarification *Explain uncertainty about the substance, date, or legal status if necessary. Do not provide frequency, quantities, diagnoses, or treatment history.State or Jurisdiction of Most Recent Use * Add Substance Remove Substance Have you ever knowingly and unlawfully manufactured, sold, delivered, distributed, or possessed with intent to distribute a controlled substance? *YesNoDo not include lawful professional duties or authorized law-enforcement activities. Controlled-Substance Conduct Substance *Approximate Date or Date Range *Nature of Conduct *Were You Arrested or Charged in Connection With This Conduct? *YesNoOutcome or Additional Explanation * Add Matter Remove Matter I understand that appointment may be contingent upon successful completion of required drug screening and a post-offer medical examination, administered at the appropriate stage of the selection process. *I acknowledge.NextPage 13 — Personal Conduct, Integrity, and Firearm EligibilityPersonal Conduct and IntegrityAnswer the following questions about conduct not already disclosed elsewhere in this questionnaire. Provide approximate dates and explain the circumstances and outcome. If you already reported a matter, identify the earlier response rather than repeating the details. Do not provide medical diagnoses, treatment information, or confidential records.Other than matters already disclosed, have you ever intentionally taken, kept, or used money or property that you knew you were not entitled to take, keep, or use? *YesNo Property-Related Conduct Approximate Date *Approximate Age at Time *Description of Conduct *Approximate Value, if Known *Did This Involve an Employer’s Money or Property?YesNoWas the Matter Reported to or Investigated by Law Enforcement?YesNoOutcome or Additional Explanation * Add Matter Remove Matter Other than matters already disclosed, have you ever knowingly committed fraud, forged a document or signature, falsified a record, or made a material misrepresentation to obtain money, property, employment, or another benefit? *YesNoDescribe the conduct, approximate date, and outcome. If unsure, explain the uncertainty. *Describe the conduct, approximate date, and outcome. If unsure, explain the uncertainty.Have you ever knowingly made a materially false statement in an official report, sworn statement, court proceeding, administrative proceeding, employment investigation, or law-enforcement investigation? *YesNoInclude intentional false statements. Do not include an honest mistake or an error you did not know was false when made.Identify the approximate date, type of report or proceeding, nature of the false statement, and outcome, including any correction. *Firearm EligibilityAre you currently prohibited by federal or state law, or by a court order, from possessing a firearm or ammunition? *YesNoUnsureIdentify the jurisdiction and any nonmedical information needed to verify the restriction or clarify your uncertainty. Do not provide diagnoses, hospitalization details, or treatment records. Contact the background investigator if a response would require medical information. *Are you, by reason of conscience or belief, opposed to the lawful use of force when necessary to perform the duties of a law-enforcement officer? *YesNoThe position may require the lawful use of physical force, including deadly force, when legally justified.Do you need to clarify, correct, or supplement any answer in this questionnaire? *YesNoUse this space to address information responsive to the questions asked. Do not provide medical information or unrelated personal details. *Identify the question or section and provide your clarification, correction, or additional information.NextPage 14 — Educational ConductEducational Conduct and DisciplineReport formal disciplinary action by a high school, college, university, technical school, or trade school. Distinguish the conduct alleged from the institution’s findings and explain any appeal or later change in the outcome. If you already disclosed a matter, identify the earlier response rather than repeating the details. Do not provide medical diagnoses, treatment information, or disability-related educational records.Have you ever been suspended, expelled, placed on disciplinary probation, or otherwise formally disciplined by a high school or post-secondary educational institution for misconduct? *YesNoInclude disciplinary action for academic dishonesty. Do not include academic probation or dismissal based solely on grades, routine classroom corrections, or withdrawal for personal reasons. Educational Disciplinary Matter Institution Name *Approximate Date *Enter MM/YYYY, an approximate year, or ‘Unknown.Disciplinary Action Taken *Identify the action, such as suspension, expulsion, or disciplinary probation.Conduct Involved *Briefly describe the conduct and identify what the institution determined.Current Status or Final Outcome *Include any pending appeal, reversal, reduction, or removal of the disciplinary action.Additional Explanation * Add Remove I have reviewed my responses and have had an opportunity to correct errors, provide explanations, and complete all applicable questions before submitting this questionnaire. *I acknowledge.NextPage 15 — Supporting DocumentsSupporting DocumentsUpload documents relevant to your application. Copies and unofficial educational records are acceptable for initial review; additional verification may be requested. Do not upload Social Security cards, medical or treatment records, or unrelated personal documents. Remove Social Security numbers and financial account numbers from supporting documents before uploading.Current Résumé Drag & Drop Files, Choose Files to Upload Upload a current résumé summarizing your employment, education, training, and relevant experience.Driver’s License Drag & Drop Files, Choose Files to Upload Upload a legible copy or image of your current driver’s license.High-School Diploma or Equivalency Documentation Drag & Drop Files, Choose Files to Upload You can upload up to 2 files. You may upload a diploma, equivalency certificate, or other record supporting the credential identified in your application. Verification may be requested later if not provided now.College or Technical Education Documentation Drag & Drop Files, Choose Files to Upload You can upload up to 5 files. Upload available transcripts, degrees, certificates, or other records supporting the education reported. If relying on college credits to meet a qualification, a transcript is the most useful supporting record. Unofficial transcripts are acceptable for initial review.Law Enforcement Certification Documents Drag & Drop Files, Choose Files to Upload You can upload up to 5 files. Upload available documentation of the Iowa or out-of-state peace-officer or reserve certifications identified in your application. Certification status may be independently verified with the issuing authority.Military Service or Veterans’ Preference Documents Drag & Drop Files, Choose Files to Upload You can upload up to 5 files. You may upload available records supporting your military-service qualification or veterans’ preference claim. Remove your Social Security number before uploading. If additional documentation is needed, the District will provide instructions and a submission deadline. Medical records are not requested here.Additional Job-Related Documents Drag & Drop Files, Choose Files to Upload You can upload up to 5 files. You may upload a cover letter, relevant training certificates, or other documents supporting your qualifications. Do not upload confidential case files, personnel-investigation records, medical records, or documents containing another person’s private information.NextPage 16 — Availability and Job RequirementsAvailability and Job RequirementsReview the scheduling and other requirements for each position selected. Assignments may include nights, weekends, holidays, training, court appearances, and emergency call-ins. Specific expectations vary by position and will be explained during the selection process.Are you willing to meet the scheduling requirements of the position or positions for which you are applying? *YesNoFull-time, certified part-time, and reserve positions may have different scheduling expectations. You may identify availability limitations below without providing personal or medical details.If selected, when could you begin employment or service? *Enter an approximate date or the notice period you would need, such as “Two weeks after accepting an offer.”If appointed to the Full-Time Police Officer position, are you willing to satisfy the District’s residency requirement within one year of appointment? *YesNoReview the District’s residency requirement provided above before answering.Performance of Law Enforcement DutiesAre you, by reason of conscience or belief, opposed to the lawful use of force when necessary to perform the duties of a law-enforcement officer?YesNoThe position may require the lawful use of physical force, including deadly force, when legally justified.NextPage 17 — Essential Functions and Application AssistanceEssential Functions and Application AssistanceReview the job description for each position selected. The District provides reasonable accommodations to qualified applicants with disabilities during the application and selection process. To request assistance, contact the Department at (563) 873-2500. Do not submit medical records or describe a diagnosis in this application.Can you perform the essential functions of the position or positions selected, with or without reasonable accommodation? *YesNoBase your response on the applicable job description. Do not identify a disability, diagnosis, or accommodation needed to perform the job in this response.Would you like the District to contact you about an accommodation for participating in the application or selection process? *Yes—please contact me.No assistance requested at this time.I will contact the Department if assistance is needed.This question concerns participation in the hiring process, such as completing the application, testing, or interviewing. Do not provide medical details here. You may request assistance later.Equal Employment Opportunity The Mar-Mac Unified Law Enforcement District is an equal opportunity employer. Applicants are evaluated on job-related qualifications in accordance with applicable federal and state law. NextPage 18 — Review and SubmitReview and Submit Your ApplicationReview your responses and supporting documents before submitting. Use the Back button to make corrections. Complete the acknowledgments and applicant certification below when your application is ready.Selection Process The selection process may include review of qualifications, interviews, applicable testing, verification of records, and a background investigation. Requirements vary by position and certification status. Applicants who advance may be asked to complete a separate background questionnaire, provide additional documents, and sign appropriate authorizations. Required medical examinations and disability-related inquiries will be addressed at the appropriate post-offer stage. The District will provide instructions concerning any required drug screening. Submitting an application does not guarantee an interview, appointment, or employment. Selection Process Acknowledgment *I have read and understand the selection-process information above.Background Investigation Applicants who advance may undergo a background investigation concerning their qualifications and suitability for the position. The investigation may include verification of identity, education, employment, certifications, military service, references, and other job-related information. Additional disclosures, releases, and authorizations will be requested as appropriate. This acknowledgment does not replace any separate authorization required to obtain particular records. Checkboxes *I understand that further consideration may require completion of a background questionnaire and appropriate records authorizations.Application Review *I have reviewed my responses and attachments and have had an opportunity to correct errors and complete all applicable questions before submission.Applicant Certification I certify that I have personally completed or reviewed this application and that the information provided is true, complete, and accurate to the best of my knowledge and belief. I understand that a material false statement, intentional omission, or misrepresentation may result in disqualification or, if discovered after appointment, disciplinary action up to and including termination. I understand that the District may request clarification, verification, or additional information concerning my qualifications. I will promptly notify the Department if I discover a material error in my application. I understand that submission or acceptance of this application does not create a contract or guarantee of employment. . Checkboxes *I have read and agree to the Applicant Certification above.Applicant’s Electronic Signature *FirstMiddleLastType your full legal name. By entering your name and selecting Submit Application, you intend this entry to serve as your electronic signature for the Applicant Certification above.Submit Application