Communications & Support Staff Application

Communications & Support Staff Employment Application Package

Parts of the Application

This form is broken down into parts, ALL parts must be filled out for this application to be submitted.

1. Personal Information
2. Background Information
3. Education and Trainning
4. Employment History
5. Residency History
6. Arrest and Court Information
7. Driving History
8. Military History
9. Personal References and Acquaintances
10. Organization Membership
11. Privacy Information
12. Drug History
13. Applicant's Certification
14. Applicant Notification and Acknowledgement

Disqualifiers

Certain disqualifiers can stop you from applying, review these before you begin: 

Drug-Use Disqualifiers 

• Use of any illegal / controlled cannabinoid substance such as marijuana, hashish, etc. within the last two (2) years from the date of the application will disqualify an applicant. Applicants who have a pattern of illegal drug use to include marijuana as defined in FSS 893.03 will be disqualified.
• Use of any narcotic or controlled substance, such as synthetic marijuana, PCP, methaqualone, cocaine, steroids, LSD, heroin, a designer drug, illegal non-prescription steroids, or any drug similar in nature in the last five (5) years will disqualify an applicant.
• Any use of a prescription drug within the last two (2) years that was not prescribed for an applicant will be evaluated by an administrative staff review. The review will consist of who the drug was obtained from, the frequency of use, the type of drug and its intended purpose.

Criminal Arrests and Convictions 

• Conviction of any felony or misdemeanor involving perjury or a false statement ever.
• Any felony driving conviction ever.
• Convictions involving moral character, perjury, or false statements as outlined in the Florida Statutes ever.
• Any convictions for DUI within the last five (5) years or any DUI convictions while employed as a law enforcement officer, including military police.
• The sale of illegal drugs or drug trafficking ever.
• Any domestic violence convictions or pleas pursuant to Florida State Statue Chapter 741 within the last five (5) years from date of conviction.
• Any arrest for vice activity - ever.

5 Year Driving History (from the final day of case disposition)

• Leaving the scene of accident (criminal).
• Driver's license suspension for points
• Driver's license suspension for refusal to submit to chemical breath test
• Four (4) moving traffic violations
• Two (2) moving violations resulting from at-fault traffic crash incidents
• Driver's license suspension resulting from delinquent child support
• Driver's license suspension for worthless checks
• Habitual traffic offender
• Fleeing and attempting to elude police with arrest and conviction
• Willful wanton reckless driving

Administrative Review

• The background and criminal activities of relatives and/or close associates of the applicant may be a basis for disqualification of the applicant if it appears that such relationships may affect the applicant's abilities to perform the duties of a law enforcement officer. (Staff Review)
• An applicant's work history or work ethics which demonstrate job instability, an unwillingness to work shifts, weekends, holidays or overtime emergencies; a work history pattern which reflects excessive tardiness, absenteeism, or an unwillingness to get along with co-workers or supervisors
• An applicant must be in good physical condition and capable of performing the functions of a Law Enforcement or Corrections Officer (Job descriptions available upon request)
• Applicants with U.S. Military experience must have been discharged from the Armed Forces with an Honorable Discharge. If an applicant receives a General discharge under honorable conditions, the discharge and re-enlistment code will be investigated and may be a disqualification.
• Nondisclosure of arrest history on application (JUVENILE OR ADULT)
• The NCSO reserves the right to review any disqualifiers from any applicant.

Personal Information

Background Information

Section Disqualifiers

• Must be a U.S. Citizen or permanent resident alien who has applied for citizenship

1. Date and Place of Birth:

Education and History

Section Disqualifiers

• Must be 19 years or older
• Be a high school graduate or equivalent

Employment History

Section Disqualifiers

• Must be 19 years or older
• Be a high school graduate or equivalent

List chronologically ALL employment beginning with present employment, including summer and part-time employment while attending school.

All time must be accounted for.

If unemployed for a period, set forth dates of unemployment. (Enter "Unemployed" for Employer)

Below:

List chronologically ALL employment AFTER your present employment, including summer and part-time employment while attending school.

All time must be accounted for. If unemployed for a period, set forth dates of unemployment.
(Enter "Unemployed" for Employer if unemployed)

Residency History

Actual places of residence for past 10 years - list chronologically all addresses, including residences while at school and in the U.S. military.

• For college on campus residences, give dormitory name, city and state.
• If residences while in the military cannot be shown as street address, indicate a complete military unit designation and location by city and state.
• If post office box, give location of post office. 
• If Rented, provide Property Owner/Manager Information 

Additional Residences

Be Sure to include all residences for the past 10 years.

Arrest and Court Information

Pursuant to Section 945.0585(6), Florida Statutes, candidate for employment with criminal justice agency may NOT lawfully deny or fail to acknowledge the arrests covered by an expunged record.

Driving History

Military History

Personal References and Acquaintances

Give three (3) references (not relatives, former or present employees, fellow employees, or school teachers) who are responsible adults of reputable standing on their communities, such as property owners, business or professional men or women, who have known you well for the past five (5) years. If retired, give former occupation.

Organization Membership

Privacy Information

THE INFORMATION CONTAINED HEREIN MAY BE CONFIDENTIAL AND NOT AVAILABLE FOR PUBLIC INSPECTION

3. Please provide information of next of kin or other person to be contacted in case of an emergency

4. Please provide information of personal or family physician to be contacted in case of an emergency

Drug History

Section Disqualifiers

• Conviction of any felony or misdemeanor involving perjury or a false statement.
• Any felony driving conviction.
• Convictions involving moral character, perjury, or false statements as outlined in the Florida Statutes.
• Any convictions for DUI within the last five (5) years or any DUI convictions while employed as a law enforcement officer, including military police.
• Arrests or convictions involving the sale of illegal drugs or drug trafficking
• Any domestic violence convictions or pleas pursuant to Florida State Statue Chapter 741 within the last five (5) years from date of conviction.
• Any arrest for vice activity.

The information contained herein MAY BE a confidential medical record under the Americans with Disabilities Act if the applicant is a rehabilitated drug or alcohol abuser or under section 119.071(4)(b) whether the medical information, if disclosed, would identify the applicant.

Nassau Country Sheriff's Office

  I understand that my employment will be contingent upon the results of a complete background investigation. I am aware that any omission, falsification, misstatement or misrepresentation will be the basis for my disqualification as an applicant or my dismissal from the Sheriff's Office. I agree to the conditions and certify that all statements made by me on this application are true, correct and complete, to the best of my knowledge. I further fully understand and consent to a polygraph examination concerning the veracity of my responses to the information requested on this application or which is discovered as a result of the background investigation, or any physical examination or drug test. I also understand that I may be fingerprinted. I understand that this employment application shall become the property of the Sheriff's Office and that it and the information received in response to the background examination are public records.
  I further understand and agree that my employment will be contingent upon the results of a complete drug test.
  I understand that the use of drugs or alcohol is not permitted, during work or duty time, whether paid or unpaid, in the areas, including vehicles, where work is performed by employees or appointees.
  I understand that my continued employment may be contingent upon the results of medical or psychological examina- tions that I may be required to take during the term of my employment.
  I further authorize the Sheriff's Office or agent of the Sheriff's Office, without need of further authorization, to obtain medical records allowed by law if I claim rights to payment or receipt of any benefit pursuant to state or federal law.
  I further agree to execute any authorization as may be required by the Health Insurance Portability Accountability Act of 1996 (HIPAA) for health care providers to release the necessary medical information to process my application for employ- ment.
  I understand and agree that any employment offered to me will be contingent upon my acceptance of compensatory time off, instead of cash, in payment for overtime hours that I work, to the extent allowed by law. I understand, however, that the Sheriff has the absolute discretion to periodically substitute cash, in whole or part, for my accrued compensatory time.
  I understand that unless otherwise defined by applicable law, any employment relationship with this office is "at will", which means that the employer may discharge me at any time with or without cause and that this "at will" relationship may not be changed unless authorized in writing by the Sheriff.
  I authorize any of the persons or organizations referenced in this application to furnish information, personal or other- wise, regarding my ability and fitness for employment with the Sheriff's Office and I release all such parties from any and all liability for any damage that might result from furnishing such information to the Sheriff's Office.
  I agree to conform to the rules, regulations and orders of the Sheriff's Office and acknowledge that these rules, regu- lations and orders may be changed, interpreted, withdrawn or added to by the Sheriff's Office, at its discretion, at any time and without any prior notice to me.

Nassau Country Sheriff's Office

APPLICANT NOTIFICATION AND ACKNOWLEDGEMENT

This form shall be completed and signed by every applicant for background screening purposes. It is recommended that a copy of the signed acknowledgement be securely retained in the applicant's personnel file for the duration of their employment with the agency.

I hereby authorize the Nassau County Sheriff's Office to process a set of my fingerprints for the purpose of accessing and reviewing Florida and national criminal history records that may pertain to me to determine eligibility for employment or licensure.

I understand the following:

• My fingerprints will be retained at the Florida Department of Law Enforcement (FDLE) and the Federal Bureau of Investigation (FBI) for the purpose of providing notice of any subsequent modifications to my criminal history record.
• A copy of any national criminal history record that may pertain to me can be obtained directly from the FBI.
• I am entitled to challenge the accuracy and completeness of any information contained in any such criminal history record pursuant to F.S. 943.056 and Title 28, CFR, Section 16.30-34.
• I am entitled, within a reasonable amount of time, to a determination as to the validity of my challenge before a final decision is made regarding my status as an employee, volunteer, contractor, or subcontractor if it is the sole factor precluding my employment or unescorted access to the secure facility.