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2. POLICE OFFICER
4. SUPPLEMENTAL APPLICATION PACKET
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10. IMPORTANT
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16. 1. You MUST attach copies of the following documents when you return your completed application. Please attach copies, as originals will not be returned.
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20. A. DRIVER LICENSE

    B. FLORIDA POLICE CERTIFICATION

    C. ANY ADDITIONAL CERTIFICATION PAPERS

    D. DD FORM 214 IF APPLICABLE
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24. 2. If offered a position, the following documents will be required prior to start date.
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28. A. BIRTH CERTIFICATE

    B. HIGH SCHOOL DIPLOMA OR G.E.D.

    C. SOCIAL SECURITY CARD

    D. CITIZENSHIP PAPERS IF APPLICABLE
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36. ATLANTIC BEACH POLICE DEPARTMENT DISQUALIFIERS
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40. THESE DISQUALIFIERS INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:
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44. * Any felony arrest (will be handled on a case by case basis)
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48. * Any misdemeanor conviction involving moral character, perjury or false statements
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52. * Any misdemeanor or criminal conviction in the last 7 years
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56. * Three or more incidents resulting in moving violations in the last 5 years
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60. * Any DUI arrest in the last 7 years
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64. * A refusal to submit to a chemical test for DUI in the last 7 years
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68. * Any driver's license suspension in the last 7 years, except due to financial responsibility
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72. * The sale of any controlled substance, ever
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76. * The use of or experimentation with marijuana within the last 5 years
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80. * The use of or experimentation with any other illegal substance in the lat 10 years (such as, but not limited to: Cocaine, Heroin, LSD, Hashish, Mescaline, PCP, Opium, Peyote, PCH, THC, designer drugs or any of their derivatives)
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84. * The use of any narcotic without the benefit of a prescription within the last 10 years. (Such as, but not limited to: Opium, Morphine, Methadone or any of their derivatives

    * Use of tobacco or tobacco products for at least one (1) year immediately preceding application.
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92. POLICE OFFICER SUPPLEMENTAL QUESTIONNAIRE
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96. Name*
97. Date*
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101. Maiden Name/Nickname or Aliases*
102. Date of Birth*
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108. Home number*
110. Work number*
112. Cell phone*
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116. e-mail address (home/work)
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120. Drivers License Number*
121. Drivers License State of Issue*
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125. (Check One)
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129. 1. Can you operate a motor vehicle?*
     -- Select One --YesNo
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133. 2. Have your driving privileges ever been restricted? *
     -- Select One --YesNo
135. If yes, state which type of suspension & reason:
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139. 3. Have your driving privileges ever been suspended or revoked?*
     -- Select One --YesNo
141. If yes, please explain.
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145. 4. Was your license restored?*
     -- Select One --YesNo
147. If yes, when?
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151. 5. Have you ever been engaged in the use of any illegal drugs? *
     -- Select One --YesNo
153. (If yes, list all drug activity, including: when, what drug used,
     and number of times).
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159. 6. Have you ever been involved in illegal sale of any drug? *
     -- Select One --YesNo
161. (If yes, please explain)
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167. 7. Have you ever abused prescription drugs?*
     -- Select One --YesNo
169. (If yes, please explain when, what drug,
     and number of times).
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175. 8. Have you ever been arrested for the commission of a misdemeanor involving moral turpitude?*
     -- Select One --YesNo
177. (If yes, please explain)
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183. 9. Have you ever been convicted for the commission of a felony?*
     -- Select One --YesNo
185. (If yes, give details)
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191. 10. Have you ever been arrested or detained by police?*
     -- Select One --YesNo
193. (If yes, please explain)
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199. 11. Have you ever been arrested, received a notice to appear, charged, convicted, pled nolo contendere or pled guilty to any criminal violation, regardless if the record was sealed or expunged?*
     -- Select One --YesNo
201. (If yes, please explain)
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207. 12. Have you ever been placed on probation?*
     -- Select One --YesNo
209. (If yes, please explain)
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215. 13. Have you ever paid a fine in excess of $50.00 or done community service in lieu of payment of fine?*
     -- Select One --YesNo
217. (If yes, give details).
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223. 14. Were you ever in the U.S. Military?*
     -- Select One --YesNo
225. If yes, What was your service number?
227. What was the highest rank held?
229. What was the date and location of your last discharge from active duty?
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235. 15. Were you ever court-martialed, tried on charges, or were you the subject of a summary court, deck court, captains mast or company punishment, or any other disciplinary action while a member of the armed forces?*
     -- Select One --YesNo
237. (If yes, please give details).
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243. 16. List any disciplinary actions taken against you in the National Guard or other reserve unit.
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247. The Police Officer Position may include duties and responsibilities which often involve high-pressure situations that can create emotional distress. Some duties may be disagreeable or unpleasant to perform. Carefully read each question below and decide whether or not this is the type of work that you are willing to perform.
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251. (Check One)
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255. Are you willing to talk to people who are emotionally upset; for example, persons who are angry, frightened, depressed or excited?*
     -- Select One --YesNo
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259. Are you willing to tolerate abusive or threatening language from people who, because of their problems, take out their emotions on you?*
     -- Select One --YesNo
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263. Are you willing to remain emotionally detached in order to respond to situations in a positive, professional and helpful manner?*
     -- Select One --YesNo
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267. Are you willing to work weekends and holidays?*
     -- Select One --YesNo
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271. Are you willing to work overtime and rotating shifts? *
     -- Select One --YesNo
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275. Are you willing to have all your telephone calls at work monitored and recorded for evaluation?*
     -- Select One --YesNo
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279. Are you willing to make immediate decisions that may affect someone's life?*
     -- Select One --YesNo
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283. What are your feelings about the use of deadly force if it becomes necessary in the performance of official duties?*
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291. PLACES LIVED
293. (Starting with current address, please list all places lived for the past ten years. Include the dates, street, city, state, zip code and landlord information (name, phone number, city, state and zip code).*
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