Instructions to the Applicant
The information you provide in this application will be used in the background investigation to assist in determining your suitability for the non-sworn position of Public Response Dispatcher.
Disqualification
There are very few automatic bases for rejection. Even issues of prior misconduct, such as prior illegal drug use, driving under the influence, theft, or even arrest or conviction are usually not, in and of themselves, automatically disqualifying. However, deliberate misstatements or omissions can and often will result in your application being rejected, regardless of the nature or reason for the misstatements/omissions. In fact, the number one reason individuals “fail†background investigations is because they deliberately withhold or misrepresent job-relevant information from their prospective employer.
The information you provide in this application will be used in the background investigation to assist in determining your suitability for the non-sworn position of Public Response Dispatcher.
- It is your responsibility to complete this form and provide all required information.
- This document must be filled out electronically and printed.
- You must respond to all items and questions. If a question does not apply to you, write “D.N.A.†(does not apply) in the space provided for your response.
- Send the completed form to your background investigator or the agency to which you are applying.
Disqualification
There are very few automatic bases for rejection. Even issues of prior misconduct, such as prior illegal drug use, driving under the influence, theft, or even arrest or conviction are usually not, in and of themselves, automatically disqualifying. However, deliberate misstatements or omissions can and often will result in your application being rejected, regardless of the nature or reason for the misstatements/omissions. In fact, the number one reason individuals “fail†background investigations is because they deliberately withhold or misrepresent job-relevant information from their prospective employer.
BOTTOM LINE: You are responsible for providing complete, accurate, and truthful responses.
1. PERSONAL INFORMATION
1. FIRST NAME
- Jose
- Luis
- Ortega
- Month: 09
Date: 17
Year: 2000
- Los Santos, SA
- [X] Male
[—] Female
[—] Other
- [—] White
[—] Black or African American
[X] Hispanic or Latino
[—] American Indian or Alaska Native
[—] Asian
[—] Flippino American
[—] Native Hawaiian or Other Pacific Islander
[—] None of the Above
[—] Two or More Races
- In feet: 5
In inches: 10
- In pounds: 165
- [X] Single
[—] Married
[—] Divorced
[—] Widow
[—] Legally Separated
[—] Unknown/Not Applicable
- Street Number & Name: 516 East Mirror Dr
City: Los Santos
State: SA
Zip: 72734
- 48876651
PROCEED TO NEXT PAGE
2. EDUCATION HISTORY
14. LEVEL OF EDUCATION
- [—] Some High School
[—] High School
[—] Some College
[—] Technical College
[—] Associate's Degree
[X] Bachelor's Degree
[—] Master's Degree
[—] Doctorate
- School Name: University of Los Santos
Enrollment Term: 09/01/2018 to 06/01/2022
Course of Study: Business Administration
PROCEED TO NEXT PAGE
3. EMPLOYMENT HISTORY
16. FIRST PLACE OF EMPLOYMENT
- Company/Agency Name: 24/7
Position: Cashier
Duties Summary: Checking out customers, cleaning store, managing inventory
Employment Term: 10/12/2022 to Present
Reason for Leaving: Currently employed
- Company/Agency Name: D.N.A.
Position: D.N.A.
Duties Summary: D.N.A.
Employment Term: D.N.A.
Reason for Leaving: D.N.A.
- Company/Agency Name: D.N.A.
Position: D.N.A.
Duties Summary: D.N.A.
Employment Term: D.N.A.
Reason for Leaving: D.N.A.
PROCEED TO NEXT PAGE
4. BACKGROUND QUESTIONAIRE
19. I HAVE A VALID SAN ANDREAS DRIVER LICENSE
- [X] Yes
[—] No
[—] Unknown
[—] Not Willing to Answer
[—] Other
- [X] Yes
[—] No
[—] Unknown
[—] Not Willing to Answer
[—] Other
- [X] LSSD Website
[—] Sheriff's Station Website
[—] Social Media
[—] College Campus
[—] Career Fair or Seminar
[—] LSSD Employee
[—] LS County Employee
[—] Family Member
[—] Friends or Neighbors
[—] Radio
[—] Billboard
[—] Other
- Spanish
- [—] Yes
[X] No
[—] Unknown
[—] Not Willing to Answer
[—] Other
- [—] Yes, I currently serve
- I currently serve in the:
- I have formerly served in the:
[—] Unknown
[—] Not Willing to Answer
[—] Other
- [—] Yes
[X] No
[—] Unknown
[—] Not Willing to Answer
[—] Other
- [—] Yes
- Indicate which state(s) and year(s) convicted:
[—] Unknown
[—] Not Willing to Answer
[—] Other
- [—] Yes
- Indicate the previous month(s) and year(s) you have used marijuana:
[—] Unknown
[—] Not Willing to Answer
[—] Other
- [—] Yes
[X] No
[—] Unknown
[—] Not Willing to Answer
[—] Other
- [—] Yes
[X] No
[—] Unknown
[—] Not Willing to Answer
[—] Other
PROCEED TO NEXT PAGE
5. DECLARATION & ACKNOWLEDGEMENT
I, the undersigned, do herein agree that the information aforementioned is true and complete to the best of my knowledge under the penalty of perjury. I further agree and understand that the information provided will be utilized by the Los Santos County Sheriff's Department for the purposes of employment & preliminary background investigation for the position of Custody Assistant. I further understand that the Los Santos County Sheriff's Department employs candidates with no regard to race, religion, sexual orientation, creed, ethnicity, veteran status, or disability. I agree that if selected to move forward with the hiring process, I will abide by the hiring standards as prescribed by the Sheriff of Los Santos County and his designated deputies.
30. SIGNATURE
30. SIGNATURE
- Jose Ortega
- Month: 09
Date: 27
Year: 2023
PROCEED TO NEXT PAGE
(( 6. OUT OF CHARACTER QUESTIONS ))
32. MY TIMEZONE
- EST
- pseudonym
- ocean honda of burlingame#9090
- SPOILER: show
- pseudonym
- D.N.A.
- [—] Yes
- Elaboration:
- [X] Yes
[—] No
- SPOILER: show
STOP — END OF APPLICATION