APPLICATION FOR SUMMER INTERNSHIP PRINCE WILLIAM COUNTY POLICE DEPARTMENT

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1 COUNTY OF PRINCE WILLIAM 9540 Center Street, Suite 101, Manassas, Virginia (703) FAX (703) POLICE DEPARTMENT Personnel Bureau Barry M. Barnard Chief of Police APPLICATION FOR SUMMER INTERNSHIP PRINCE WILLIAM COUNTY POLICE DEPARTMENT Police Personnel Bureau Courthouse Professional Center 9540 Center Street, Suite 101 Manassas, VA (703) Fax (703) (800) Please read all instructions carefully and answer all questions completely. Incomplete applications will not be given consideration! Summer internship applications must be received in the Police Personnel Bureau by April 7. Internship duration is approximately 8 weeks. Type or print your answers in BLACK ink. If additional space is needed for any item on this form, entries should be continued on a separate sheet; number each entry to correspond to the number of the question on the form. Your name should be on each additional sheet. Be as specific as possible for all requested information. A cover letter addressed to the Police Personnel Manager must also be submitted, and should include number of credit hours to be obtained through an internship, the internship hours required by your college or university, and the college/university reporting requirements, (evaluations, special projects, etc.) and, resume, You must also include letter(s) of recommendation from a college faculty member (preferably a Department Chair), and your college transcripts. A NATIONALLY ACCREDITED LAW ENFORCEMENT AGENCY An Equal Opportunity Employer Printed On Recycled Paper

2 Name: Last Social Security Number: - - First MI Address: Street # City State Zip C d Have you ever been employed by Prince William County Government? Yes No If Yes, to Department: List any relatives that currently work for the Prince William County Government: Name Department Relationship Person to contact in case of emergency: Name/Relationship: Phone: Home ( ) Work ( ) HIGH SCHOOL School attended: Year Graduated: Address: COLLEGE OR UNIVERSITY Name: Major: GPA: Expected Graduation Date: Current Class (Jr., Sr.): Internship hours required for graduation: Credit hours to be obtained through this internship: 2

3 Employment History Applicants must complete all requested information. Please provide in reverse chronological order your work experience, beginning with your most recent employment. 1 Position Title: Machines/equipment used: 2 Position Title: Machines/equipment used: 3

4 3 Position Title: Machines/equipment used: Please briefly describe your interest in the Prince William County Police Department. Include how you believe this internship will benefit you and how it will apply to your future career goals. 4

5 1. Are you a citizen of the United States? Yes No 2. Have you ever been terminated or forced to resign or have you ever resigned in order to avoid being terminated? Yes No If yes, explain: 3. Have you ever been convicted of a crime? (Exclude any offenses committed before your eighteenth birthday which were adjudicated in a Juvenile Court or committed and expunged under a Youth Offender Law and traffic violations for which you only paid a fine). Yes No If yes, explain: 4. Do you have a valid driver s license? State of issue: Yes No 5. May inquiry be made of your present employer regarding your qualifications? Yes No 6. Is there any reason why you cannot perform the duties of the position applied for? Yes No 7. Have you ever applied with the Prince William County Police Department or Public Safety Communications Center before? Yes No If yes, when and final outcome? 8. Are you fluent in any language other than English? Yes No If yes, specify: 9. This Department has a body art (tattoo) policy that basically prohibits more than 4 visible tattoos when wearing shorts and short-sleeved shirts. Additionally, members are prohibited from having more than 2 visible tattoos on any limb. Members are permitted to have a wedding ring tattoo on the ring finger of the left hand no wider than ½ inch. Tattoos are to be no larger than the size of your hand extended with fingers adjoined. Furthermore, tattoos should not be considered offensive by a reasonable person. Do you have any tattoos or body art that would violate this policy? Yes No 10. Have you used, purchased, grown/manufactured, or sold any illicit substances in the past twelve months? Yes No 11. Have you ever, as a juvenile or adult, experimented or used any type of illicit substance or drug including marijuana, cocaine, hallucinogens, or prescriptions not your own? Yes No If yes, please explain what drug(s), date of last use, number of times used, and age of last use. PLEASE BE SURE TO SIGN YOUR APPLICATION I hereby certify that this application is a complete record and that all entries given are true and accurate to the best of my knowledge. I understand that any attempt to practice deception or fraud in this application is grounds for disqualification or termination. I consent to verification of all information contained on this employment application and I authorize Prince William County Police Department to contact my references and previous employers to determine my qualifications for this position. Signed: Date: 5