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Due to the sensitive and confidential nature of information stored within the Huntersville Police Department, we have determined these questions are necessary to fully and adequately evaluate applicants for volunteer positions within our agency. All applicants are subject to a thorough background investigation.
All information provided will be verified for accuracy during the background investigation. Any admissions to information requested will not necessarily exclude you from consideration; however, incorrect statements or omissions may be grounds for denied employment.
Disclosure of your Social Security Number is voluntary and is used to make a positive identification of you in the background investigation. Failure to provide this information may result in delaying the application process and may result in inaccurate information/records being assigned to your application packet.
No initials. If you do not have a middle name use "NMN"
Providing the last four of your SSN is optional at this time. However, for you to successfully complete the application process, you will be required to provide it to the volunteer coordinator within a week of submitting your application. Without it, the Huntersville Police Department can not conduct a background investigation.
Due to state regulations, we are required to complete a thorough background check on everyone who works in our facility (due to the sensitive information housed here). This is why we need the last four of your SSN.
HPD will not share confidential information with you via email; nor will we ask for any confidential information. If you have information you wish to share with the volunteer coordinator, please do so by calling 704.464.5359.
Include the complete physical address with the city, state and zip code.
You can list additional previous employers here and explain any gaps of employment for the previous five years. (Please follow the same format as above NAME, ADDRESS, DATES and SUPERVISOR).
Immediate family includes: mother, father, siblings, children, grand children (to include adopted relatives, in-laws, step relatives or anyone for which you are currently a relationship with).
Give names, date of charge, type of charge or investigation:
List the charge(s), date(s) and final disposition of the case(s):
List the charge(s), date(s) and final disposition of the case:
List the date(s), reason(s) and final disposition(s)
Provide the date, type of drug used and explanation for use:
First and last name, email address and phone number (repeat for each reference).
Please list the name of the organization, a contact persons name, email address and or phone number.
To Whom It May Concern:
I am an applicant for a volunteer position with the Huntersville Police Department. In order to determine my suitability, I understand the Huntersville Police Department will conduct a thorough investigation of my personal/ professional records and personal background. It is in the public’s interest that all relevant information concerning my personal and employment history be disclosed to the Huntersville Police Department. Therefore I hereby request and authorize (releasing from all liability) any bank, credit union, lending or financial institution, credit bureau/reporting agency, consumer report agency, retail business establishment, former and present employer, educational institution, governmental agency, criminal and civil courts, certification/licensing commission, military organization, and other individual agency to produce and provide copies of any and all information to the authorized agent of the Huntersville Police Department regarding me whether of a privileged or confidential nature.
Moreover, I hereby release the Huntersville Police Department, Town of Huntersville, North Carolina and its agents from any civil or criminal liability whatsoever for seeking such requested information and for evaluating such information as it relates to my application with the Town of Huntersville and I hereby release the issuing agency and its agents, both individually and collectively, from any and all liability for damages of whatever kind, which may at any time result because of compliance with this authorization and request.
I further waive all right to inspect or review any information compiled in reference to my application for employment.
I further acknowledge and waive my rights of confidentiality, thus releasing the Huntersville Police Department and its’ representative from civil or criminal liability; for the release of any information obtained within the application process sought by any other Law Enforcement Agency or any Branch of Government (be it Local, State or Federal) I have applied with.
A copy of this document is considered valid, just as the original.
I have read and fully understand the above statements titled as “Authorization for Release of Information".
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
This field is not part of the form submission.
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