APPLICATION FOR EMPLOYMENT - Newtonsheriffga
NEWTON COUNTY SHERIFF’S OFFICE A P P L I C AT I O N F O R E M P L OY M E N T Y S ASSOC GA. NT F W N IA S H ERI NE TO F’ ORGI A TIO N GE CO U 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 www.newtonsheriffga.org An Equal Opportunity Employer. TO W COMMITTED TO EXCELLENCE NE Ezell Brown, Sheriff
NEWTON COUNTY CO U SHERIFF’S OFFICE EZELL BROWN, SHERIFF ORGI A IA F NE S H E RI F’ W N TIO N GE TO Y Y IA GA. S ASSOC GA. NT W N S ASSOC NT F NE S H ERI TO ORGI A TIO N GE F’ CO U INSTRUCTION SHEET To be considered for employment, applicants must meet the following minimum qualifications: Applicants must be at least 21 years of age for Deputy Sheriff positions, 18 years of age for Detention Officer and civilian positions, possess a high school diploma or equivalent, possess a valid driver’s license, honorable discharge (if prior military), be a US citizen, have no adverse driving record nor felony or family violence convictions, and be of good moral character. The applicant must complete ALL FORMS ACCURATELY, LEGIBLY, and COMPLETELY. DO NOT LEAVE ANY BLANK SPACES. If a question does not apply to you write “N/A” in the space. PRINT ANSWERS to questions with a BLACK INK PEN ONLY. Be absolutely truthful, a false statement or the omission of requested information is grounds for automatic rejection before appointment or termination after employment. If you answer “yes” to a question, you need to be complete in explaining the circumstances. Do not omit an explanation because you think the incident was minor and of no importance. If the space is insufficient to complete your answers, please attach supplementary pages. The following documents are required to begin the application process and must be mailed in with the application: A copy of your high school diploma or equivalent A copy of your birth certificate A photo copy of your current driver’s license A full MVR from Department of driver’s services A copy of your COMPASS or ASSET scores The completed application and required documents must be returned to Newton County Human Resources at the following address: Newton County Human Resources 1113 Usher Street Ste. 203 Covington, GA 30014 **NOTE: Some pages require Notary. Upon submission, your application and supporting documents will be reviewed for completeness. If your application is incomplete, it will be returned to you. Applications that are complete and meet the minimum requirements will be forwarded to the Newton County Sheriff’s Office, Office of Professional Standards for processing. The hiring process includes but is not limited to the following: an oral board interview, an intensive background investigation, voice stress analysis, and, following a conditional job offer, medical examination, drug screen and psychological examination. If you have any questions concerning this process please contact the Newton County Sheriff’s Office at (678) 625-1212. The Newton County Sheriff’s Office is an Equal Opportunity Employer and does not discriminate on the basis of race, color, National origin, sex, religion, or disability in employment or provision of services. The following documents are required if they are applicable to you and must be mailed in with the application: Long DD214 Form, showing Honorable Discharge (if former military) Certified College Transcripts (sealed) Any name change documents Citizenship Papers Copy of Bankruptcy discharge papers COMMITTED TO EXCELLENCE 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 www.newtonsheriffga.org
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 Position Applied For: Deputy Sheriff Detention Officer Civilian Reserve Deputy I. PERSONAL INFORMATION Name (Last, First, Middle) Social Security # Home Address (Street Number/Name, City, State, Zip Code) How long have you lived at your current address? Home Telephone: Business Telephone: Cellular Telephone: Email Address: Yes Are you a citizen of the United States? No Yes If no, are you a permanent resident? No Place of Birth (City, County, State/Country) Have you ever used another name or had your name changed? Yes No (This includes Maiden Names, Former Married Names, Adopted Names, Nicknames, etc.) If you answered yes, please provide the following information: Previous Name Date of Change Location of Change Have you ever applied with the Newton County Sheriff’s Office before? Yes Position last applied for and date: Are you currently employed with Newton County? Were you previously employed with Newton County? Yes Yes If yes: Date started/ Date left/ Position(s) held: Page 1 of 28 No No Reason for Change No
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 Do you have any relatives employed with Newton County? Yes No If yes, indicate each: Relative’s Name Relationship Department Employed How did you learn of this position? Please list all organizations, Clubs and Associations which you are now, or have ever been a member of: Name of Organization Date Began Date Ended Position Held Please list any technical skills that you possess that may relate to the position applied for: Skill How Long Related Training Please list any foreign language that you have learned and the extent of your proficiency: Language Proficiency (some, moderate, fluent) Page 2 of 28
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 II. EDUCATION What is your highest grade completed? Are you a high school graduate? Yes No Name of High School: Dates Attended: Address (Street Number/Name, City, State, Zip Code) How long have you lived at your current address? Telephone Number: Date Graduated: Yes Did you receive a GED certificate? No Name of School or Local Board of Education: Address (Street Number/Name, City, State, Zip Code) List all colleges, universities, business/technical schools or graduate schools that you have attended: Name of school Address Start Date End Date Major/Minor Degree Earned III. LAW ENFORCEMENT EXPERIENCE List all law enforcement or corrections agencies that you have applied with. List the agency name, date of application, and status of your application (how far are you or did you get in the process). Agency Name Date of Application Application Status Page 3 of 28 Contact name (if known)
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 III. LAW ENFORCEMENT EXPERIENCE Are you currently a Georgia P.O.S.T. Certified Peace Officer Yes No Georgia P.O.S.T. PBLE number: Have you been awarded any Georgia P.O.S.T. certification or certification from another state? Yes If yes, please provide: State of Issuance Type of Certification Certification Number How many years and months experience do you have as a certified law enforcement officer? Is your Law Enforcement, Correction, Jailer, Probation, or Parole Officer Certification under investigation Yes No by any state or federal Law Enforcement Training Council? If yes, please attach a narrative on a separate sheet of paper explaining in detail the cause for the investigation. Has your Law Enforcement, Correction, Jailer, Probation, or Parole Officer certification ever been revoked Yes No or placed on probation by any state or federal Law Enforcement Training Council? If yes, please attach a narrative on a separate sheet of paper explaining in detail the cause for the revocation or probation. Page 4 of 28 No
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 III. LAW ENFORCEMENT EXPERIENCE List ALL disciplinary action received while working in a law enforcement position. Include any oral or written reprimands, suspensions, demotions or termination, the date of the action, reason for the action, and indicate whether you are currently involved in an internal investigation. Agency Name Disciplinary Action Date of Action Internal Affairs Investigation (open or closed) Have you ever resigned from employment while under active internal investigation? Yes Reason for disciplinary action No If yes, explain: IV. MILITARY SERVICE Have you ever served in any branch of the United States Armed Forces? Yes This also includes Reserves, National Guard, and Coast Guard. If yes, what branch? No What type of military discharge did you receive? (Honorable, Dishonorable, General, Under Honorable Conditions, Entry Level Separation, Medical, etc.) Be specific: Have you ever been involved in, or been accused of being involved in, a subversive act against the United States Yes Government, or any other government, such as mutiny, treason, sabotage, espionage, etc.? If yes, fully explain on a separate attached narrative. Page 5 of 28 No
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 IV. MILITARY SERVICE Applicants that served in the military must complete the following: Branch of Service Enlistment Period Highest Rank Held Service Number Have you ever been court-martialed, tried on charges, or subject of an Article 15, company punishment, or any other Yes No disciplinary action while a member of any branch of the Armed Forces? *If yes, please explain in detail on a separate attached narrative. Include type of disciplinary action taken, branch of service, date of action, disposition of action and explanation of offense. V. PERSONAL REFERENCES Please list five (5) personal references. These must be people who are responsible adults of reputable standing in their community and who have known you for at least 4 years. They may not be relatives, anyone living within your household or current/former employers. Confirm that all the addresses and telephone numbers are current before submitting your application. Reference 1: Name: Relationship: Contact Phone Number: Years Known: E-mail Address: Address (Street Number/Name, City, State, Zip Code) Occupation: Page 6 of 28
NEWTON COUNTY SHERIFF’S OFFICE APPLICATION FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 Reference 2: Name: Relationship: Contact Phone Number: Years Known: E-mail Address: Relationship: Contact Phone Number: Years Known: E-mail Address: Relationship: Contact Phone Number: Years Known: E-mail Address: Relationship: Contact Phone Number: Years Known: E-mail Address: Address (Street Number/Name, City, State, Zip Code) Occupation: Reference 3: Name: Address (Street Number/Name, City, State, Zip Code) Occupation: Reference 4: Name: Address (Street Number/Name, City, State, Zip Code) Occupation: Reference 5: Name: Address (Street Number/Name, City, State, Zip Code) Occupation: Page 7 of 28
NEWTON COUNTY SHERIFF’S OFFICE APPLICATION FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 VI. NEIGHBOR REFERENCES Please provide three (3) current neighbor references. The neighbor reference may live next door to you or within three (3) houses or apartment units in any direction of your residence. Please confirm that all addresses and telephone numbers are current before submitting your application. Reference 1: Name: Relationship: Contact Phone Number: Years Known: E-mail Address: Relationship: Contact Phone Number: Years Known: E-mail Address: Relationship: Contact Phone Number: Years Known: E-mail Address: Address (Street Number/Name, City, State, Zip Code) Occupation: Reference 2: Name: Address (Street Number/Name, City, State, Zip Code) Occupation: Reference 3: Name: Address (Street Number/Name, City, State, Zip Code) Occupation: Page 8 of 28
NEWTON COUNTY SHERIFF’S OFFICE APPLICATION FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 VII. RESIDENCE HISTORY Please list all of your addresses for the last ten years. Start with your present address. You must include all permanent, temporary, part-time, military, and school addresses in which you have resided. FROM MO/YR TO MO/YR STREET ADDRESS CITY Page 9 of 28 COUNTY STATE ZIP
NEWTON COUNTY SHERIFF’S OFFICE APPLICATION FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 VIII. EMPLOYMENT HISTORY List all jobs worked in the last 15 years. Include military, volunteer experience, self-employment, internships, and periods of unemployment, ALL part-time work and ALL full-time work. For any gap of unemployment, write UNEMPLOYED under “Employer” section and explain your means of support (i.e. parents, spouse income, unemployment benefits, etc.). All periods of time should be accounted for during the last fifteen years. A resume may be attached ONLY as additional information and WILL NOT be accepted in lieu of completing this section. If more space is needed, attach additional pages including all information that is asked. Begin with your most recent or current employment. Please provide current telephone numbers (including area code) for all employers. Employer 1: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Employer 2: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Page 10 of 28
NEWTON COUNTY SHERIFF’S OFFICE APPLICATION FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 VIII. EMPLOYMENT HISTORY List all jobs worked in the last 15 years. Include military, volunteer experience, self-employment, internships, and periods of unemployment, ALL part-time work and ALL full-time work. For any gap of unemployment, write UNEMPLOYED under “Employer” section and explain your means of support (i.e. parents, spouse income, unemployment benefits, etc.). All periods of time should be accounted for during the last fifteen years. A resume may be attached ONLY as additional information and WILL NOT be accepted in lieu of completing this section. If more space is needed, attach additional pages including all information that is asked. Begin with your most recent or current employment. Please provide current telephone numbers (including area code) for all employers. Employer 3: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Employer 4: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Page 11 of 28
NEWTON COUNTY SHERIFF’S OFFICE APPLICATION FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 VIII. EMPLOYMENT HISTORY List all jobs worked in the last 15 years. Include military, volunteer experience, self-employment, internships, and periods of unemployment, ALL part-time work and ALL full-time work. For any gap of unemployment, write UNEMPLOYED under “Employer” section and explain your means of support (i.e. parents, spouse income, unemployment benefits, etc.). All periods of time should be accounted for during the last fifteen years. A resume may be attached ONLY as additional information and WILL NOT be accepted in lieu of completing this section. If more space is needed, attach additional pages including all information that is asked. Begin with your most recent or current employment. Please provide current telephone numbers (including area code) for all employers. Employer 5: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Employer 6: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Page 12 of 28
NEWTON COUNTY SHERIFF’S OFFICE APPLICATION FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 VIII. EMPLOYMENT HISTORY List all jobs worked in the last 15 years. Include military, volunteer experience, self-employment, internships, and periods of unemployment, ALL part-time work and ALL full-time work. For any gap of unemployment, write UNEMPLOYED under “Employer” section and explain your means of support (i.e. parents, spouse income, unemployment benefits, etc.). All periods of time should be accounted for during the last fifteen years. A resume may be attached ONLY as additional information and WILL NOT be accepted in lieu of completing this section. If more space is needed, attach additional pages including all information that is asked. Begin with your most recent or current employment. Please provide current telephone numbers (including area code) for all employers. Employer 7: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Employer 8: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Page 13 of 28
NEWTON COUNTY SHERIFF’S OFFICE APPLICATION FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 VIII. EMPLOYMENT HISTORY List all jobs worked in the last 15 years. Include military, volunteer experience, self-employment, internships, and periods of unemployment, ALL part-time work and ALL full-time work. For any gap of unemployment, write UNEMPLOYED under “Employer” section and explain your means of support (i.e. parents, spouse income, unemployment benefits, etc.). All periods of time should be accounted for during the last fifteen years. A resume may be attached ONLY as additional information and WILL NOT be accepted in lieu of completing this section. If more space is needed, attach additional pages including all information that is asked. Begin with your most recent or current employment. Please provide current telephone numbers (including area code) for all employers. Employer 9: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Employer 10: Employer: Telephone Number: Dates Employed (from/to) Address (Street Number/Name, City, State, Zip Code) Total time employed: Job Title: Out of business? Supervisor’s Name: Brief description of duties: Reason for leaving: Page 14 of 28
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 IX. APPLICANT QUESTIONNAIRE If you answer YES to questions 4-29, you must explain in full detail on the explanation sheet provided with this questionnaire. Be sure to indicate the question number that you are addressing. 1. Are you available to work any hour of the day, day of the week, including holidays and be available during unusual occurrences Yes No for call-outs? 2. Will you consent to a thorough background investigation of your character? Yes No 3. Will you consent to a medical examination by a physician and a psychological evaluation upon a conditional offer of employment? Yes No 4. Have you ever been rejected for employment, for any reason, by any law enforcement agency? If yes, what agency and why? Yes No 5. Have you ever been terminated by any law enforcement agency? If yes, give the agency, date of termination, and reason. Yes No 6. Have you ever been terminated or asked to resign from any job? If yes, list the name of the employer(s), dates of employment, Yes No and reason for termination or resignation under pressure. 7. Have you ever been physically arrested or given a copy of charges for violation of any city, municipal, state, or federal law? Yes No 8. Have you ever appeared in any court (including juvenile) as a defendant to answer any city, municipal, state, or federal criminal charge? If so, give the court in which you appeared and the disposition of the case (i.e. conviction, First Offenders, charges Yes No dismissed, etc). 9. Have you ever been detained by any law enforcement representative, been the subject of any criminal investigation, or been Yes No named as the accused on a warrant? If yes, explain in detail. 10. Have you ever received any tickets for traffic violations (excluding parking tickets) on any license that you have held since you began driving? If yes, list type of violation, date received, jurisdiction, and disposition (i.e. fine, suspension, charges dismissed). Yes No 11. Have you ever used, tried, ingested, or experimented with marijuana (including as a juvenile or even one experimental use)? If Yes No yes, write the number of times used, the first date used, and the date of last use. 12. Have you ever used, tried, ingested, or experimented with any other type of illegal narcotics or dangerous drugs (i.e. heroin, Yes No cocaine, hashish, speed, LSD, anabolic steroids, etc.)? If yes, indicate what type of drug and when you used it? 13. Have you ever sold any type of illegal drug, delivered illegal drugs, shared drugs with another person, or directed another person Yes No where to buy drugs? If yes, indicate what type of drug and when. Page 15 of 28
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 IX. APPLICANT QUESTIONNAIRE If you answer YES to questions 4-29, you must explain in full detail on the explanation sheet provided with this questionnaire. Be sure to indicate the question number that you are addressing. 14. Have you ever used, tried, ingested, or experimented with any drug legally prescribed to another person? If yes, indicate what Yes No type of drug and when. 15. Have you ever filed or declared bankruptcy, had any judgments, repossessions, foreclosures, or collections? Yes 16. Do you know of anything that might prevent you from obtaining this position? 17. Have you ever been sued? Yes 18. Have you ever had your wages garnished? 19. Are there any unpaid judgments against you? 20. Are you delinquent in property taxes or other taxes? Yes No No No Yes No Yes No Yes No 21. Have you ever had a charge, complaint, or lawsuit filed against you alleging the use of excessive force? Yes Yes 22. Have you ever had a charge, complaint, or lawsuit filed against you alleging false arrest? No No Yes 23. Have you ever been a complainant, victim, or been involved in a complaint of domestic violence? No 24. Do you have any visible tattoos and/or brands? Visible is defined as the area that is exposed to public view in short sleeves or Yes No the areas that are exposed in shorts. If yes, provide location and meaning of each one on the explanation sheet. 25. Are you now or have you ever been, engaged in any business as an owner, partner, or corporate member? Yes 26. Have you received written reprimands from supervisors or employers for not doing your job correctly or conduct violations? Yes No 27. Have you been counseled or received warning for being late or absent from work? Yes No 28. Have you ever been suspended from a job for a period of time with or without pay? Yes No 29. Have you purposely omitted any information from your employment application? Page 16 of 28 Yes No No
NEWTON COUNTY SHERIFF’S OFFICE 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 APPLICATION FOR EMPLOYMENT X. EXPLANATION TO APPLICANT QUESTIONNAIRE Please make sure that all explanations are detailed, accurate, and true. Be sure to list the number to the question that you are explaining. Attach additional sheets if necessary. Page 17 of 28
NEWTON COUNTY SHERIFF’S OFFICE 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 APPLICATION FOR EMPLOYMENT X. EXPLANATION TO APPLICANT QUESTIONNAIRE Please make sure that all explanations are detailed, accurate, and true. Be sure to list the number to the question that you are explaining. Attach additional sheets if necessary. Page 18 of 28
NEWTON COUNTY SHERIFF’S OFFICE 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 APPLICATION FOR EMPLOYMENT X. EXPLANATION TO APPLICANT QUESTIONNAIRE Please make sure that all explanations are detailed, accurate, and true. Be sure to list the number to the question that you are explaining. Attach additional sheets if necessary. Page 19 of 28
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 XI. APPLICANT SWORN STATEMENT I certify that I have read and understand all questions and instructions in this application, and that my answers are true and complete. I understand that this application is not an offer of or a contract for employment. I understand that any untrue statement in this application may result in my dismissal at any time during my employment with the Newton County Sheriff’s Office. I understand that any intentional false statement will result in my disqualification from the hiring process and may result in criminal prosecution under O.C.G.A. 16-10-20 and 16-10-71. Name (First, Middle, Last) Signature: Date: Notary Public: Date: THIS FORM MUST BE SIGNED AND MAILED TO: NEWTON COUNTY HUMAN RESOURCES DEPARTMENT. ELECTRONIC SUBMISSIONS WILL NOT BE ACCEPTED. Page 20 of 28
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 XII. EMPLOYEE REIMBURSEMENT AGREEMENT The Official Code of Georgia Annotated Title 35 Chapter 8 Section 22 (O.C.G.A. 35-8-22) states the following: 35-8-22. (GCA § 92A-2122.1) Reimbursement for Peace Officer’s Mandated or Formalized Training (a) Unless otherwise provided by an employment contract to the contrary, if the State of Georgia or any county or municipality thereof employs a peace officer and said peace officer is hired by another agency within 15 months after completing mandated or formalized training requirements, then the total expense of training, including salary paid during training, shall be reimbursed by the hiring agency to the State of Georgia or any county or municipality thereof which initially paid for such training. If said officer is hired by another agency during a period of 15 to 24 months after mandated or formalized training requirements are completed, then one-half of the total expense of training, including salary paid during training, shall be reimbursed by the hiring agency to the State of Georgia or any county or municipality thereof which initially paid for such training. The council shall set standards for reimbursement by hiring agencies based upon actual expenses incurred in mandated or formalized training by individual departments. (b) The State of Georgia or any county or municipality thereof which initially paid for the training of a peace officer shall submit an itemized, sworn statement to the new employer of the peace officer and shall demand payment thereof and may enforce collection of such obligation through civil remedies and procedures. (c) Effective July1, 2003, in order for the State of Georgia or any county or municipality thereof to demand reimbursement, the demanding governmental unit must be able to document that the peace officer in question signed an acknowledgment of the terms of this Code section or an employment contract specifying the provisions of this Code section prior to such peace officers employment with the demanding governmental unit. Otherwise, this Code section shall not apply to such demand for reimbursement. I, (Applicant), have read in full and do agree to abide by the provisions of O.C.G.A 35-8-22 Reimbursement for Peace Officer’s Mandated or Formalized Training. Applicant Signature: Date: Notary: Date: THIS FORM MUST BE SIGNED AND MAILED TO: NEWTON COUNTY HUMAN RESOURCES DEPARTMENT. ELECTRONIC SUBMISSIONS WILL NOT BE ACCEPTED. Page 21 of 28
NEWTON COUNTY APPLICATION SHERIFF’S OFFICE FOR EMPLOYMENT 15151 Alcovy Rd., NE Covington, Georgia 30014 Ph: (678) 625-1212 XIII. NEWTON COUNTY SHERIFF’S OFFICE CONSENT WAIVER I, , do hereby authorize a review of and full disclosure of all records concerning myself to any duly authorized agent of the Newton County Sheriff’s Office, or to any authorized agent of a criminal justice agency or any private agency upon request of the Newton County Sheriff’s Office, whether the said records are of a public, private, or confidential nature. The intent of this authorization is to give my consent for full and complete disclosure of the records of military service records, “authority to release law enforcement or criminal records or information from a law enforcement agency;” educational institutions; financial or credit institutions, including records of loans, the records of commercial or retail credit agencies (including credit reports and/or rating) and financial statements and records wherever filed; medical and psychiatric treatment and/or consultation including hospitals, clinics, private practitioners, and the U.S. Veterans Administration; employment and pre-employment records, including background reports, efficiency ratings, c
the Newton County Sheriff's Office at (678) 625-1212. The Newton County Sheriff's Office is an Equal Opportunity Employer and does not discriminate on the basis of race, color, National origin, sex, religion, or disability in employment or provision of services. NEWTON COUNTY. SHERIFF'S OFFICE. EZELL BROWN, SHERIFF. GA. N E W T O N C O U .
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