Please check the job(s) for which you are applying. *
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Full Name (as listed on Drivers License/ Identification Card) *
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Address *
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Phone Number *
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Texas Drivers License or Identification Number *
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Date of Birth & Place of Birth *
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Emergency Contact: Name, Phone Number, Address *
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Personal Reference #1: Name, Address, Phone Number, Relationship *
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Personal Reference #2: Name, Address, Phone Number, Relationship *
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Personal Reference #3: Name, Address, Phone Number, Relationship *
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Employment Information #1 (Most Recent): Company Name, Supervisor Name, Phone Number, Address, Job Title, Dates of Employment *
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Employment Information #2: Company Name, Supervisor Name, Phone Number, Address, Job Title, Dates of Employment
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Employment Information #3: Company Name, Supervisor Name, Phone Number, Address, Job Title, Dates of Employment
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Highest Level of Education
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Are you Bilingual
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Have you EVER been ARRESTED, CHARGED, OR CONVICTED of ANY crime? DO NOT include traffic tickets unless you were taken into custody. *
If YES, please explain.
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Do you have a license to carry? *
Do you have any special skills you feel would be an asset to our program?
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Are you a graduate of a Citizen Police Academy Program?
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Please explain what motivated you to volunteer your valuable time and talent to help support the Hutto and Hutto ISD Police Departments *
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I hereby acknowledge all information provided on this form is correct and authorize the City of Hutto Police Department and Hutto ISD Police Department to conduct a personal background check. *