Date of birth
*
MM
DD
YYYY
Last 4 of your SSN
*
Do you have a valid Louisiana State Civil Service test score?
*
Are you Post Certified?
*
Have you ever applied with the Pineville Police Department?
*
Have you ever applied with any other law enforcement agency?
*
Have you ever interviewed with any law enforcement agency?
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Phone
*
(###)
###
####
High School
*
Diploma/Certifcate
*
College
Degree
Have You Ever Lived Outside of Louisiana
*
If You Answered Yes to the Above Question - Please List the States
List Any Aliases
Have you ever served in the any branch of the United States Military?
*
Yes
No
Currently Serving
Military Status
*
Active Duty
Retired
Reserve
None Applicable
Military Discharge Status
*
Honorable
General
Medical
Dishonorable
None Applicable
Drug Usage
*
Check All that Apply
Explain Any Usage Including Dates of Usage
Have You Ever Been the Subject of Employee Misconduct
*
Yes
No
Have you ever been terminated from a job?
*
Yes
No
If So, Explain.
Have You Ever Been Arrested
*
Yes
No
If So, List Details Including Charges, Dates & Disposition
Are You Aware of Any Pending Criminal Charges
*
Yes
No
How many at fault motor vehicle accidents have you had in the last 5 years?
*
0
1
2
3+
How many traffic citations have you had in the last 5 years?
*
0
1
2
3+
Have you had any negative interactions with the police in the last 3 years?
*
Yes
No
Are you regularly associated with known felons?
*
Yes
No
Do you have reliable transportation?
*
Yes
No
Are you currently involved with any civil litigation?
*
Yes
No
Please Read and Check the Box Confirming that you Understand.
*
