Job Form | Trotwood, Ohio

An Equal Opportunity Employer

The city of Trotwood complies with Equal Employment Opportunity (EEO) laws and regulations. Furthermore, the City of Trotwood considers qualified applicants for positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or military/veteran status, genetic information, or sexual orientation.

Thank you for your voluntary assistance in our recruitment and EEO compliance and tracking efforts. The information you provide on this page will be used solely for recruitment and EEO purposes in compliance with State and Federal laws and guidelines.

“Race, color, religion, creed, country of origin, ancestry, sex, age, physical disability, political affiliation, or other factors not pertinent to the performance shall not be considered in recruitment, examination, appointment, training, promotion, retention, salary determination or other conditions of employment, except in cases where specific age, sex or physical requirements constitutes a ‘bona fide occupational qualification.’ Discrimination for any of the reasons stated above is, therefore, unlawful and constitutes the denial of civil rights and an affront to human dignity.”

Please select one

Female
Male

Please check all that apply

White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa.
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.
Asian (Not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
American Indian or Alaska Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.
Two or more races (Not Hispanic or Latino): All persons who identify with more than one of the above five races.
Veteran of the United States military, including Reserves or National Guard
Person with disabilities: a physical or mental impairment that substantially limits one or more major activities, including the functions of caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working; a record of a physical or mental impairment, or being regulated as having a physical or mental impairment.

PLEASE COMPLETE ALL SECTIONS AND EACH QUESTION COMPLETELY AND ACCURATELY

This employment application is to be used for all internal, external, and seasonal or temporary job postings. We encourage you to provide a resume and cover letter in addition to this application. If you require special accommodations to participate in the application or selection process due to disability, please contact Human Resources at (937) 854-7224 or 854-7223.
Applications are kept on file for at least one year.
A separate application must be submitted for each position for which you are applying.
Applications must specifically reflect all requirements for the position, including experience and/or required courses of study. Please answer all questions accurately and completely.
By signing this application, you are affirming that all information you provide is accurate and complete.
Falsifying information may be grounds for disqualification and/or termination, if employed in the future.

Application For Employment

Select a job position you are applying for OR upload completed documents*

What job position are you applying for?*

You must download and fill-out these additional forms. These documents must be uploaded and submitted with your application.

Homeland Security Supplement to Police Application

Lateral Hire Application – Waiver And Release

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Social Security #*

Desired Salary*

Today's Date*

What shifts are you available for?*

Select All
1st
2nd
3rd
Full-time
Part-time
Temporary
Seasonal

Are you at least 18 years of age?*

Yes
No

Have you ever worked for the City of Trotwood?*

Yes
No

If yes, when?

Do any of your friends or relatives work here?*

Yes
No

If yes, give name and relationship

Are you a U.S. citizen, or legally authorized to work in the United States?*

Yes
No

Are you currently employed?*

Yes
No

May we contact your current employer?*

Yes
No

Are you on layoff, and subject to recall?*

Yes
No

Please answer the following questions if the position you are applying for requires driving:

Do you have a valid Driver’s License?*

Yes
No

Do you have a Commercial Driver’s License?*

Yes
No

If yes, give Driver License # and State

If yes, give Commercial Driver License # and State

Education

High School

Address

From

To

Did you graduate?

Yes
No

Diploma

College

Address

From

To

Did you graduate?

Yes
No

Diploma

Other

Address

From

To

Did you graduate?

Yes
No

Diploma

Military Service

Branch

From

To

Are you subject to a Reserve obligation?

Yes
No

Rank at Discharge

Employment History

Company #1

Phone

Job Title

Address

Supervisor

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for leaving

May we contact your previous supervisor for a reference?

Yes
No

Company #2

Phone

Job Title

Address

Supervisor

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for leaving

May we contact your previous supervisor for a reference?

Yes
No

Other Qualifications/Specialized Training/Skills

List any additional information covering your qualifications including any licenses or professional certificates that you hold which are applicable for this position such as typing skills, Office Equipment, Computer Software, fluency in languages other than English, and any heavy equipment/tool skills:

Police Applicant: OPOTA Certified

Yes
No

Currently Enrolled in Police Academy?

Yes
No

If yes, what is graduation date

EMS: Level

EMS: Certification #

FIRE: Level

FIRE: Certification #

If not certified as a Paramedic or a Level II Firefighter, provide the date expected to receive certification

Professional References

Please list three professional references (not related to you)

List References

Name	Relationship	Company	Phone	Address

Upload Documents

Upload resume, cover letter, and any other additional forms here

Drop files here or

How did you hear about us?

Check all that apply

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Friend
Relative
School
Inquiry
Other

Dear Applicant:

On behalf of the City of Trotwood, I would like to thank you for your interest in becoming a member of the Trotwood Police Department. Please complete the supplemental application in as much detail as possible. When you return your supplemental application, you must include the following documentation if it applies to you:

Certified Copy of your Birth Certificate
Certified Copy of Your High School Diploma or GED Certificate or Certified Transcript
Certified Copy of your College Transcript and a regular copy of your College Degree
Copy of your Ohio Peace Officer Training Council Certification
Copy of Training Certificates related to law enforcement duties

Your failure to complete the application or to provide the requested documentation may prevent any further processing of you as a candidate for employment.

The selection process includes the ability to successfully pass:

Written entry-level examination
Oral Interview/s
Background investigation including a pre-employment truth verification examination and drug screen
Psychological examination
Pre-employment physical examination including a drug screen

Reconsideration, re-evaluation and re-testing are subject to the following constraints:

Candidates must observe a twelve (12) month waiting period before being eligible for re-testing.
Candidates may retest the written, oral, and / or physical testing components.
The psychological testing component and background investigation are not eligible for re-testing or reconsideration for a period of three years.

The entire selection process may take from two months to one year, depending on operational needs. Please direct questions to the Human Resource Department (937) 837-7771.

Thank you again for your interest in the Trotwood Police Department.

Along with your application for employment, please complete or include the following with your application.

Applicant’s Waiver to release information (contained in the application packet)
A copy of a valid Ohio Driver’s License
A copy of your State Certification
A copy of your current CPR card

Your application packet, including the items mentioned above, should be submited online or forwarded to

City of Trotwood
Human Resource Department
3035 Olive Road
Trotwood, Ohio 45426

If you have any questions regarding the application packet, please contact Fire Chief Richard Haacke at (937) 854-7257.

Employment Application Supplement – Police Officers, Firefighters/EMTS

The following questions are in addition to those requested on the original employment application. These questions may be used in a pre-employment truth verification examination. Please answer all questions. If explaining an answer please state the relevant question it applies to within the comment box.

Financial Information (Please explain any responses of yes within the comment/ explanation box).

Are you now delinquent in any financial obligations?*

Yes
No

Do your monthly bills exceed your take home pay?*

Yes
No

Do you, your spouse or ex-spouse have any civil actions pending?*

Yes
No

Are you delinquent in child support payments?*

Yes
No

Have you ever been garnished, filed for bankruptcy, or been declared bankrupt?*

Yes
No

Employment (Please explain any responses of yes within the comment/ explanation box).

Have you ever been discharged or asked to resign from a job?*

Yes
No

Have you ever filed a workmen’s compensation claim?*

Yes
No

Have you ever been tardy (late) to work?*

Yes
No

Have you ever used more than 2 sick days in a year?*

Yes
No

Have you ever received any disciplinary action (verbal or other) at work?*

Yes
No

General Information (Please explain any responses of yes within the comment/ explanation box).

Have you ever been involved in a physical altercation while at work?*

Yes
No

Have you ever threatened to harm another person for reporting your performance deficiencies to your supervisor?*

Yes
No

Have you ever solicited someone to commit a crime or violent act?*

Yes
No

Have you ever violated a company policy in exchange for a bribe or payoff?*

Yes
No

As an adult, have you ever stolen anything?*

Yes
No

Have you ever received or filed for compensation (ADC, General Assistance, etc.) that you were not legally eligible or entitled to receive?*

Yes
No

Have you ever knowingly bought or sold stolen property?*

Yes
No

Have you ever illegally used any narcotic drug at any time?*

Yes
No

Have you ever used a hallucinogen (including marijuana)?*

Yes
No

Have you ever used any prescription drugs or any other drug for any purpose other than the purpose for which they were intended, or used any such drugs for an extended period of time without a prescription for any reason?*

Yes
No

Have you ever been involved in glue sniffing or used any other such chemical agents for the purpose of obtaining a state of intoxication?*

Yes
No

Do you drink alcohol?*

Yes
No

Do you have any problems because of gambling?*

Yes
No

Do you have any problems controlling your temper?*

Yes
No

Do you have any hatreds or prejudices toward others because of their race, sex, national origin, religion, or color that would be detrimental to you performing your job?*

Yes
No

Have you ever been involved in an automobile accident?*

Yes
No

Have you ever had your drivers license suspended or revoked?*

Yes
No

If it became necessary in the course of your duties to take a human life, would you have any reluctance to do so?*

Yes
No

Have you ever lied under oath or in an investigation, as a police officer?*

Yes
No

Have you ever knowingly filed a false report or made false statements on an official document?*

Yes
No

Have you ever abused your authority?*

Yes
No

Did you intentionally omit information from your employment application?*

Yes
No

If a police officer, have you ever used excessive force against another?*

Yes
No

If a police officer, have you ever used your position for personal financial gain?*

Yes
No

Have you ever been involved in a Domestic Violence incident?*

Yes
No

Comments / Explanations

If yes to any of the above please explain here.

If yes to any of the above please make sure to explain.
An applicant may not be hired as a peace officer in the City of Trotwood due to any disqualifying offense which would preclude an individual from performing the functions of a peace officer, including any offense under section 2923.13 of the Revised Code.
An applicant may not be hired as a firefighter in the City of Trotwood due to any disqualifying offense which would preclude an individual from performing the functions of a firefighter, including any offense under section 2909.03 of the Revised Code.
An applicant that makes false statements during the selection process, including the application and pre-employment information shall be disqualified.

Disqualifying Offenses

2923.13 Having weapons while under disability.
Unless relieved from disability under operation of law or legal process, no person shall knowingly acquire, have, carry, or use any firearm or dangerous ordnance, if any of the following apply:

The person is a fugitive from justice.
The person is under indictment for or has been convicted of any felony offense of violence or has been adjudicated a delinquent child for the commission of an offense that, if committed by an adult, would have been a felony offense of violence.
The person is under indictment for or has been convicted of any felony offense involving the illegal possession, use, sale, administration, distribution, or trafficking in any drug of abuse or has been adjudicated a delinquent child for the commission of an offense that, if committed by an adult, would have been a felony offense involving the illegal possession, use, sale, administration, distribution, or trafficking in any drug of abuse.
The person is drug dependent, in danger of drug dependence, or a chronic alcoholic.
The person is under adjudication of mental incompetence, has been adjudicated as a mental defective, has been committed to a mental institution, has been found by a court to be a mentally ill person subject to court order, or is an involuntary patient other than one who is a patient only for purposes of observation. As used in this division, "mentally ill person subject to court order" and "patient" have the same meanings as in section 5122.01 of the Revised Code.

Whoever violates this section is guilty of having weapons while under disability, a felony of the third degree.
For the purposes of this section, "under operation of law or legal process" shall not itself include mere completion, termination, or expiration of a sentence imposed as a result of a criminal conviction. Amended by 130th General Assembly File No. TBD, HB 234, §1, eff. 3/23/2015.

(C)(1) Except as otherwise provided in division (C)(2) of this section, an appointing authority shall not appoint or employ a person as a permanent, full-time paid firefighter or a volunteer firefighter if the fire chief has requested a criminal records check pursuant to division (A) of this section and the criminal records check indicates that the person previously has been convicted of or pleaded guilty to any of the following:
1. A felony;
2. A violation of section 2909.03 of the Revised Code;
3. A violation of an existing or former law of this state, any other state, or the United States that is substantially equivalent to any of the offenses described in division (C)(1)(a) or (b) of this section.
Notwithstanding division (C)(1) of this section, an appointing authority may appoint or employ a person as a permanent, full-time paid firefighter or a volunteer firefighter if all of the following apply:
1. The fire chief has requested a criminal records check pursuant to division (A) of this section.
2. The criminal records check indicates that the person previously has been convicted of or pleaded guilty to any of the offenses described in division (C)(1) of this section.
3. The person meets rehabilitation standards established in rules adopted under division (E) of this section.
(3) If a fire chief requests a criminal records check pursuant to division (A) of this section, an appointing authority may appoint or employ a person as a permanent, full-time paid firefighter or volunteer firefighter conditionally until the criminal records check is completed and the fire chief receives the results. If the results of the criminal records check indicate that, pursuant to division (C)(1) of this section, the person subject to the criminal records check is disqualified from appointment or employment, the fire chief shall release the person from appointment or employment.
(D) The fire chief shall pay to the bureau of criminal identification and investigation the fee prescribed pursuant to division (C)(3) of section 109.578 of the Revised Code for each criminal records check conducted in accordance with that section. The fire chief may charge the applicant who is subject to the criminal records check a fee for the costs the fire chief incurs in obtaining the criminal records check. A fee charged under this division shall not exceed the amount of fees the fire chief pays for the criminal records check. If a fee is charged under this division, the fire chief shall notify the applicant at the time of the applicant's initial application for appointment or employment of the amount of the fee and that, unless the fee is paid, the applicant will not be considered for appointment or employment.
(E) The appointing authority shall adopt rules in accordance with Chapter 119. of the Revised Code to implement this section. The rules shall include rehabilitation standards a person who has been convicted of or pleaded guilty to an offense listed in division (C)(1) of this section must meet for the appointing authority to appoint or employ the person as a permanent, full-time paid firefighter or a volunteer firefighter.
(F) A fire chief who intends to request a criminal records check for an applicant shall inform each applicant, at the time of the person's initial application for appointment or employment, that the applicant is required to provide a set of impressions of the person's fingerprints and that the fire chief requires a criminal records check to be conducted and satisfactorily completed in accordance with section 109.578 of the Revised Code.
(G) As used in this section:
1. "Appointing authority" means any person or body that has the authority to hire, appoint, or employ permanent, full-time paid firefighters and volunteer firefighters under section 737.08 of the Revised Code.
2. "Criminal records check" has the same meaning as in section 109.578 of the Revised Code.
3. "Superintendent of BCII" has the same meaning as in section 2151.86 of the Revised Code.

Effective Date: 04-09-2003

Applicant’s Statement and Authorization

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

Agreement Required*

I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed one (1) year. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that any employment relationship with the City of Trotwood is of an “at will” nature, and means that I (as an employee if hired) may resign at any time and the Employer may discharge me with or without cause. It is further understood that this “at-will” employment relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate discharge. I also understand that I am required to abide by all rules and regulations of the employer.

I hereby acknowledge that I, voluntarily and of my own free will, have applied for employment with the City of Trotwood with the understanding that the City may use a variety of screening procedures to evaluate my qualifications and suitability for appointment. I have been advised that these screening procedures might include, but are not limited to interviews, criminal record checks, consumer credit reports, driving record checks, polygraph examinations, written testing, reference checks, background investigations drug/alcohol testing, and other physical and mental assessments used to evaluate whether I am capable of performing the requirements of the position for which I am applying. However, no screening procedures will be implemented to compile or assess my genetic information or used for any discriminatory purpose.

I Agree

Place initials here*

My initials below acknowledges that I have read and understand the above statements.

Date Signed*

Applicant’s Waiver To Release Information*

As an applicant for employment with the City of Trotwood, I understand and agree that the City of Trotwood may make a thorough investigation of my past employment, education, credit history, criminal record and other activities related to the selection process.

I hereby release the City of Trotwood, its employees, agents and representatives and all others from any liability or damages which may result from the exchange of the information requested.

I also authorize and request all persons to whom this request is presented, having information relating to or concerning me, to furnish such information to a duly appointed representative of the City of Trotwood.

I also release persons, agents, representatives and others providing such information from any damages or liability which may result in the provision of requested information.

Information to be disclosed may include:

•Past/Present Employment Information
•Educational background
•Criminal Record
•Driving Record
•Polygraph Examination
•Psychological Examination
•Physical Examination
•Credit History
•Drug Screen

These records will be maintained on file in the Human Resources Department.

Signed release will expire sixty (60) days from date of signed release.

Firefighters/EMTS - Signed release will expire in conjunction with applicable eligibility lists for employment or 12 months from date of signature, whichever is greater.

I Agree

Applicant’s Waiver To Release Information - Police*

I hereby authorize and request all persons to whom this request (original and/or reproduction) is presented, having information relating to or concerning me, to furnish such information to a duly appointed officer of the Trotwood Police Department.

I am aware that this information may be of a personal nature and may otherwise be protected from disclosure by my constitutional, statutory, or common law privileges. I hereby expressly waive all privileges, which may attach to such communication or disclosure and release all persons, firms, and corporations from all claims, of any nature, as a result of said communications or disclosure.

Information to be disclosed:

•Past/Present Employment Information
•Educational background
•Criminal Record
•Driving Record
•Polygraph Examination
•Psychological Examination
•Physical Examination
•Credit History
•Drug Screen

These records will be maintained on file in the Human Resources Department.

These records may be released / mailed / faxed to the attention of the Trotwood Police Department, 3035 Olive Road, Trotwood, Ohio 45426, Fax Number (937-854-5045).

I Agree

Place initials here*

My initials below acknowledges that I have read and understand the above statements.

SSN #*

Date of Birth*

Date Signed*

Agreement Required - Police*

I certify that all information provided in this employment application is true and complete. I understand that any false statement or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.

I authorize and agree to cooperate in a thorough investigation of all statements made herein and other matters relating to my background and qualifications. I understand that any investigation conducted may include a request for employment and educational history, credit reports, consumer reports, investigative reports, driving records, and criminal history.

I understand that compliance with the City of Trotwood Police Department’s Code of Conduct and General Orders is a condition of my employment.

I understand I will be required to successfully pass a drug screening examination.

I understand that all application materials are subject to investigation.

I Agree

Place initials here*

My initials below acknowledges that I have read and understand the above statements.

Date Signed*

Authorization To Obtain Consumer Credit Report*

PURSUANT TO 15U.S.C. 1681 (b) (a) (b) (2).

I hereby authorize the release of a consumer report for employment purposes to the TROTWOOD POLICE DEPARTMENT. I understand that inquiry may include, but not limited to: my credit history, criminal arrest and conviction history, motor vehicle records, and credit check.

A photocopy or fax copy of this authorization shall be effective as the original. This authorization will remain in force until I specifically revoke it in writing.

This authorization is given pursuant to the Fair Credit Reporting Act, 15 U.S.C. 1681.

I Agree

Place initials here*

My initials below acknowledges that I have read and understand the above statements.

Date Signed*

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An Equal Opportunity Employer

PLEASE COMPLETE ALL SECTIONS AND EACH QUESTION COMPLETELY AND ACCURATELY

Application For Employment

Education

Military Service

Employment History

Other Qualifications/Specialized Training/Skills

Professional References

Upload Documents

Dear Applicant:

Employment Application Supplement – Police Officers, Firefighters/EMTS

Disqualifying Offenses

Applicant’s Statement and Authorization

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