Weymouth Police Department 140 Winter Street Weymouth, MA 02188

Transcription

1 Weymouth Police Department 140 Winter Street Weymouth, MA To: Police Candidate Your name has been certified by the Massachusetts Human Resources Division as being eligible for the position of police officer for the Town of Weymouth. If you are no longer interested in appointment to this department as a police officer, complete, sign and return then enclosed refusal form. Otherwise, retain this form. If you are still interested in appointment as a police officer, complete the attached application packet. Answer all questions EXACTLY as specified. You must sign five (5) release forms and the No Smoking affidavit, and have the application notarized on the last page. Enclose the application in the manila envelope provided, seal it and return it to my office with seven (7) days. There are seven (7) more components in the application process: I. Preliminary Interview with Captain of Support Services Review of application Overview of police position Compensation & benefits package II. Intensive Background Investigation Interviews with employers, neighbors, spouse, etc. Criminal and driver history checks (State and Federal) III. Appearance before Candidate Review Panel Oral interview by police officials Recommendations made to the Chief of Police IV. Comprehensive Medical Examination at Quincy Hospital Medical history review Physical examination, x-rays and blood/lab testing V. Physical Screening for Police Academy Physical Abilities Test VI. Psychological Screening Four written examination Interview with psychologist Role-play exercises VII. Briefing and Outfitting for Police Academy Selected uniform items furnished Payroll and benefits processing/enrollment 1

2 Preliminary interviews will be scheduled shortly after I examined the application packet. You will be notified when to appear. If you would prefer that your present employer not be contacted at this time, note this. At some point in the process, however, such contact will be necessary. When you appear for your interview, you must bring the following: 1. Your social security card; 2. Your Massachusetts driver s license; 3. One copy of your high school diploma, if applicable; 4. One copy of your higher education degree, if applicable; 5. One copy of your birth certificate; 6. One copy of your military discharge, if applicable; 7. One copy of your DD214 service discharge form, if you are a veteran; 8. Police Academy certificate, if applicable; 9. One copy of your motor vehicle registration. You should not consider this a notice of appointment. At the conclusion of step II shown on page one of this form, the Chief of Police will select candidates to fill existing positions and extend a conditional offer employment which is contingent upon successful completion of the remaining steps. Failure to appear when scheduled without advance notification or non-compliance with outlined procedures may result in your disqualification. If you have any questions, you may contact me at (781) Ext

3 To The Applicant: Read this introduction carefully before answering any questions. The Civil Rights Act of 1964 prohibits discrimination in employment because of race, color, religion, sex, national origin or disability, as does the Americans with Disabilities Act. Federal Law also prohibits discrimination on the basis of age with respect to certain individuals. The Laws of Massachusetts also prohibit some or all of the above stated discrimination as well as some additional types, such as discrimination based upon ancestry, sexual orientation and marital status. Questions with an (*) immediately to the left of the questions are optional. Although the information is useful I our examination of applicants, your decision not to answer any or all of the asterisk questions will not be held against you. PERSONAL HISTORY A. Name: (First) (Middle) (Last) Address: (Number and Street) City/Town: State/County: Zip Code: Date of Birth: Social Security No.: B. Other Names Used: Give any other names by which you have been legally known (if any): Name: Date(s) When Used: Why Used: Name: Date(s) When Used: Why Used: C. How long have you lived at this address? Phone: (Home) (Business) 3

4 D. Neighbor s Name, Address and Telephone Number who can verify above: Name: Address: Phone: F. Weight (without clothes): Height (without shoes): G. In chronological order, please state every place you have resided within the past ten years. Include address while attending school, if away from home, and all military addresses, (Note: Your present address should be listed on the first line below.) From Month/Year To Month/Year Address (Apt. #) City/Town State Landlord s Name And Telephone # 4

5 H. List all credit card accounts for which you are responsible. (Give account name, e.g. Macy s, account numbers and current balance). Card Name Account Number Current Balance I. Do you own a home [ ], rent [ ], live with parents [ ], other [ ]? If other, please elaborate If you own a home, give the name and the address of the mortgage holder: Mortgage Holder: Address: Phone: K. Do you own any other real estate? Yes [ ] No [ ]. If yes, give details. Address State Mortgage Held By Mortgage Holder s Phone # Type of Property (Residential, Rental, Commercial, etc..) I. Are you lawfully eligible for employment in the United States? Yes [ ] No [ ] M. Do you have a relative employed by this municipality? Yes [ ] No [ ]. If yes, please give name and relationship: 5

6 N. Do you personally know any police officers working in this department? Yes [ ] No [ ]. If yes, name and rank (if known): O. Are you willing to work any shift, including, for example, 4 P.M. to midnight or midnight to 8:00 a.m. during the week, and holidays if required? Yes [ ] No [ ]. If no, why not? P. If you application is considered favorably, on what date can you start work? Q. Do you possess a valid driver s license from the Commonwealth of Massachusetts? Yes [ ] No [ ]. Driver s License Number: R. Was your driver s license in this state, or any state, ever suspended or revoked? Yes [ ] No [ ]. If yes, give details: S. Have previously submitted an application for any employment with this municipality? If yes, give the name of the agency, position sought and when. T. Have you ever worked for this municipality before? If yes, give the name of the agency, position and when so employed. 6

7 EDUCATION A. List the name and address of the following schools you attended and dates of graduation. School Name, Address and Phone # Graduated Yes/No Number of Years Attended Degree Major High School College Graduate Other: Equivalency, etc. Courses Now Studying: B. Were you ever dismissed from a school or was any disciplinary action, including scholastic probation, ever taken against you during your scholastic career? Yes [ ] No [ ]. If yes, give school, date and action taken: School: Date: Action Taken: C. List awards, honors, citations, positions held in school organizations, athletic endeavors, any other special recognition you received while attending school. Also list any special recognition you have received in your community since you left school. (Exclude those organizations and awards which by their nature, name or character, indicate the religion, race or national origin of its members.) D. List any special abilities, interests, sports or hobbies along with degrees of proficiency: 7

8 E. Indicate your proficiency in each phase of each foreign language as none, good, or fluent. Language None Speak Good Fluent Understand Good Fluent Read Good Fluent Good Write Fluent Spanish French Italian German Russian Greek Chinese Portuguese Vietnamese Japanese Other F. Are you a member of the Bar? Yes [ ] No [ ]. If yes, when admitted and which state(s) or Federal Courts? G. Please list any office machines, special equipment or computer systems with which you have experience. H. Do you have any court suits pending against you? Yes [ ] No [ ]. If yes, give details: I. Have you ever been sued or had your wages garnished? Yes [ ] No [ ]. If yes, give details: 8

9 J. Do you now owe money for traffic fines? Yes [ ] No [ ] Do you now owe money for parking tickets? Yes [ ] No [ ] Do you now owe money for excise taxes? Yes [ ] No [ ] Do you now owe money for any moving violations? Yes [ ] No [ ] Do you owe money for income taxes? Yes [ ] No [ ] If you answered yes to any of the above, please give complete details including the amount owed and to whom it is owed. 9

10 EMPLOYMENT HISTORY A. In reverse chronological order, list all employments (including summer and part-time employments while attending school). All time must be accounted for. If unemployed for a period, set forth the dates of unemployment. (Use additional sheets of paper if necessary). Applicants may also include verifiable work performed on a volunteer basis. Dates Rates of Pay From Month/Year To Month/Year Name and Address of Employment Start Finish Supervisor s Name and Title Phone # Reason for leaving: Dates Rates of Pay From Month/Year To Month/Year Name and Address of Employment Start Finish Supervisor s Name and Title Phone # Reason for leaving: Dates Rates of Pay From Month/Year To Month/Year Name and Address of Employment Start Finish Supervisor s Name and Title Phone # Reason for leaving: 10

11 Dates Rates of Pay From Month/Year To Month/Year Name and Address of Employment Start Finish Supervisor s Name and Title Phone # Reason for leaving: Dates Rates of Pay From Month/Year To Month/Year Name and Address of Employment Start Finish Supervisor s Name and Title Phone # Reason for leaving: Dates Rates of Pay From Month/Year To Month/Year Name and Address of Employment Start Finish Supervisor s Name and Title Phone # Reason for leaving: Dates Rates of Pay From Month/Year To Month/Year Name and Address of Employment Start Finish Supervisor s Name and Title Phone # Reason for leaving: 11

12 Dates Rates of Pay From Month/Year To Month/Year Name and Address of Employment Start Finish Supervisor s Name and Title Phone # Reason for leaving: B. Have you ever been fired or forced to resign because of misconduct or unsatisfactory employment? Yes [ ] No [ ]. If yes, give details. C. Are you eligible for rehire with each of your former employers? Yes [ ] No [ ]. If no, please explain: 12

13 MILITARY SERVICE Have you ever served on active duty in the Armed Forces of the United States or the National Guard? Yes [ ] No [ ]. If yes, what was the highest rank attained? If yes, please complete each of the following: A. General Information Branch of Military Service: Serial Number: Type of Discharge: Date of Discharge: Dates of Active Duty: From: To: Member of Reserve? Yes [ ] No [ ] Branch: B. Was any type of disciplinary action taken against you in the Military Service? Yes [ ] No [ ]. If yes, please explain: C. Are you now or were you formerly in the National Guard? Present [ ] Former [ ] Never [ ] If you are a member of the National Guard and attend drills, meetings, or camps, give the name of the unit and location. Summer Camp or Similar Training Attendance: From: To: Location: D. Do you claim Veterans Preference under Civil Service Law? Yes [ ] No [ ] Basis: [ ] Active Duty prior to June 6, 1976 [ ] Active duty in Lebanon [ ] Active Duty in Panamanian Intervention Force [ ] Active Duty in Grenada [ ] Active Duty in Persian Gulf [ ] Other (Explain: ) 13

14 If served on Active Duty, list dates: E. If you were ever a member of the Armed Services, were you court-martialed? Yes [ ] No [ ]. If yes, please explain: 14

15 REFERENCES A. List three references (not relatives, in-laws, for or present employers, fellow employees or school teachers) who are responsible adults, have reputable standing in their community and who have known you for at least five (5) years. All persons to whom you refer may be asked to appraise your character, ability, experience, personality and other qualities. First Reference Name: Address: Phone: How does this person know you? How long has this person known you? Second Reference Name: Address: Phone: How does this person know you? How long has this person known you? Third Reference Name: Address: Phone: 15

16 How does this person know you? How long has this person known you? 16

17 CRIMINAL RECORD Note: With regard to questions contained in this section, under Massachusetts Law, you may answer no record if any of the following circumstances are applicable: 1. You have never been arrested for violation of a criminal statue; 2. You have been arrested but have never been tried for a criminal offense; 3. You have been tried for a criminal offense but were not convicted; 4. You have a first conviction for any of the following misdemeanors: a. Drunkenness b. Simple assault c. Speeding d. Minor traffic violation e. Affray or f. Disturbance of the peace 5. You have not been convicted of a criminal offense with five years before the date of this application and you have been convicted of misdemeanors where the date of conviction or the termination of incarceration, if any, occurred more than five years before the date of this application; 6. You have felony or misdemeanor convictions which have been sealed pursuant to Massachusetts Law; or 7. You have juvenile delinquency or child in need of services complaints which were not transferred to Superior Court for prosecution. A. Have you ever been arrested or convicted of a felony? Yes [ ] No [ ] B. Have you been arrested or convicted of a misdemeanor? Yes [ ] No [ ] C. Have you ever received a speeding ticket or a minor traffic violation? Yes [ ] No [ ] D. If your answer to any of the three preceding questions (a, b, c) is yes please describe the offense involved, the date of the offense, the court in which you were convicted, and any mitigating circumstances. Please include Docket Number: 17

18 Full Description of Offense Dates of Offense Court and Docket Number Disposition (finding, Sentence & Probation) and mitigating circumstances. E. Have you ever been arrested or convicted of a sexual offense? Yes [ ] No [ ]. If yes, please state the following: Full Description of Offense Dates of Offense Court and Docket Number Disposition (finding, Sentence & Probation) and mitigating circumstances. 18

19 F. Have you ever been arrested or convicted of a narcotic offense? Yes [ ] No [ ]. If yes, please state the following: Full Description of Offense Dates of Offense Court and Docket Number Disposition (finding, Sentence & Probation) and mitigating circumstances. G. Have you ever been sentenced to imprisonment after conviction of a crime? Yes [ ] No [ ]. If yes, please state the following: Full Description of Offense Dates of Offense Court and Docket Number Disposition (finding, Sentence & Probation) and mitigating circumstances. 19

20 H. Are you now under charge for any for any criminal offense in which you are awaiting trial or final disposition? Yes [ ] No [ ]. If yes, please state the following: Full Description of Offense Dates of Offense Court and Docket Number Disposition (finding, Sentence & Probation) and mitigating circumstances. I. Have you been or are you currently the subject of any petition for restraining order requested or issued pursuant to c.209 or other abuse prevention statues of the Massachusetts General Laws or similar laws of other states? Yes [ ] No [ ]. If yes, please explain when and where. Date Police Department Charge/Court/Disposition Docket Number 20

21 J. Have you ever been, or are you now, a defendant in any civil court action? Yes [ ] No [ ]. If yes, give the nature of the action and court. Nature of Action Court Docket Number 21

22 LICENSES A. Do you have experience with firearms? Yes [ ] No [ ]. If yes, please explain: B. Have you ever been issued a license to carry firearms? Yes [ ] No [ ]. If yes, please specify: Issued By Date Issued Reason Firearms License Number C. Have you ever applied for and been denied a license to carry a firearm? Yes [ ] No [ ]. If yes, please provide details, including the date of denial, person denying application and reason: D. Have you ever been issued a Firearms Identification Card? Yes [ ] No [ ]. If yes, please specify: Issued By Date Issued Card Number 22

23 E. Have you ever applied for and been denied a Firearms Identification Card? Yes [ ] No [ ]. If yes, please provide details, including the date of denial, person denying and reason: F. If you answered yes to question B or D above, was the license to carry of Firearms Identification Card ever revoked or suspended? Yes [ ] No [ ]. If yes, please provide details: 23

24 PERSONAL DECLARATIONS In order to qualify for future employment as a Weymouth Police Officer, fill out this form completely. Do not skip any questions. Your response must be clear and legible. Most of these questions concern your past behavior. A Yes answer to these questions will not necessarily disqualify you from consideration. Some questions may require an explanation. If so, attach your typed response to this form on a separate sheet. WARNING: Complete responses to each and every question is mandatory. Please include all incidents. Omissions of any and all information may be cause for disqualification and your name may be removed from Civil Service eligibility. I have read the above statement and understand the requirements. Signature: Print Name: Date: D.O.B.: A. Education Section 1. Were you ever dismissed, censured, suspended from school, college or university? Yes [ ] No [ ] 2. Have you ever been compelled to withdraw from class or course for any reason? Yes [ ] No [ ] 3. Have you ever been accused of: a. Plagiarism? Yes [ ] No [ ] b. Assisting another person during an exam? Yes [ ] No [ ] c. Receiving assistance during an exam? Yes [ ] No [ ] 4. For each yes, write or type your version of the incident on a separate sheet of paper. Be sure to number your response to match the number of the particular questions. B. Driving Record 1. As a driver, have you received a written warning from a police officer in Massachusetts? Yes [ ] No [ ] 2. As a driver, have you ever received a citation from a police officer in Massachusetts? Yes [ ] No [ ] 3. As a driver, have you ever been involved in an automobile accident in an y state? Yes [ ] No [ ] 4. If yes, how many automobile accidents have you been involved in? 5. Have you ever driven a vehicle while under the influence of alcohol or drugs? Yes [ ] No [ ] 24

25 6. For each yes answer to a question in this section, write your version of the incident on a separate sheet of paper. Be sure to number your response to match the number of the particular question. C. Employment 1. Have you ever or have you been accused of: a. Stolen from employer? Yes [ ] No [ ] b. Lied to an employer about the number of hours you worked? Yes [ ] No [ ] c. Been paid for hours that you did not work? Yes [ ] No [ ] d. Punched another employee s time card? Yes [ ] No [ ] e. Reported for work under the influence or either drugs or alcohol? Yes [ ] No [ ] f. Had an accident while working? Yes [ ] No [ ] g. Fought with other workers? Yes [ ] No [ ] h. Been disciplined by an employer for any reason? Yes [ ] No [ ] i. Resigned from a job to avoid being fired? Yes [ ] No [ ] 2. For each yes answer to a question in this section, write your version of the incident on a separate sheet of paper. Be sure to number your response to match the number of the particular question. 3. During the past three years, what is the total number of work days you have missed? D. Drug Use / Experimentation 1. Have you ever used or possessed the following substances: a. Marijuana? Yes [ ] No [ ] b. Cocaine? Yes [ ] No [ ] c. PCP? Yes [ ] No [ ] d. Hashish? Yes [ ] No [ ] e. Methamphetamine? Yes [ ] No [ ] f. Psilocybin? Yes [ ] No [ ] g. LSD? Yes [ ] No [ ] h. Heroin? Yes [ ] No [ ] i. Morphine? Yes [ ] No [ ] 25

26 j. Any other illegal drug? Yes [ ] No [ ] 2. Have you ever used or possessed the following prescription drugs without a prescription: a. Valium? Yes [ ] No [ ] b. Barbiturates? Yes [ ] No [ ] c. Codeine? Yes [ ] No [ ] d. Sleeping pills? Yes [ ] No [ ] e. Prescription diet pills? Yes [ ] No [ ] f. Amphetamines? Yes [ ] No [ ] 3. For each Yes answer in this section, you are required to answer, on a separate sheet of paper, the following questions: E. Use of Alcohol a. What form of the drug did you take? (crack, powder, pill) b. How was it administered? (smoked, sniffed, injected, etc.) c. What was the last date you used the drug? 1. Have you ever: a. Experienced memory loss after alcohol use? Yes [ ] No [ ] b. Been involved in a fight while drinking? Yes [ ] No [ ] A Yes answer requires you to submit a written version of the incident on a separate sheet of paper. Be sure to number your response to match the number of the particular question. c. Been involved in an accident while drinking? Yes [ ] No [ ] A Yes answer requires you to submit a written version of the incident on a separate sheet of paper. Be sure to number your response to match the number of the particular question. d. Been taken into police custody while drinking? Yes [ ] No [ ] A Yes answer requires you to submit a written version of the incident on a separate sheet of paper. Be sure to number your response to match the number of the particular question. e. Missed work because of drinking? Yes [ ] No [ ] F. Other 26

27 1. Have you ever applied for a special police officer s license? Yes [ ] No [ ] 2. Have you ever applied for a bond or a job that requires a bond? Yes [ ] No [ ] 3. Have you ever used an ATM machine withdrawal to pay a gambling debt? Yes [ ] No [ ] 4. Have you ever lied about a gambling win or loss? Yes [ ] No [ ] When? Amount $: 5. Have you ever had sex with another person without their consent? Yes [ ] No [ ] 6. Have you ever had sex with a person under the age of 16? Yes [ ] No [ ] 7. Have you ever used drugs or alcohol to seduce a sex partner? Yes [ ] No [ ] 8. Have you ever paid for sexual favors? Yes [ ] No [ ] If you answered YES to any question from 5 through 8, write your version of the incident on a separate sheet of paper. Be sure to number your response to match the number of the particular question. 9. Have you ever been ordered, or agreed to pay child support? Yes [ ] No [ ] If the answer is yes, are you current in your payments? Yes [ ] No [ ] 10. Is there anything about your life that could subject you to blackmail? Yes [ ] No [ ] 11. Have you ever sued someone or have you ever been sued? Yes [ ] No [ ] 12. Are there any incidents in your life (not previously mentioned) which your desire to explain? Yes [ ] No [ ] If you answered Yes to questions 10 through 12, write your version of the incident on a separate sheet of paper. Be sure to number your response to match the number of the particular question. G. Social Responses 1. How many times a week do you drink? 2. How much do you drink a week? 3. How much money do you spend on alcohol a week? 4. How many times a year do you get drunk? 5. When was the last time you were drunk? 27

28 6. List all the places where you have taken vacations for the past five years in this state: When Where Any Contact With Police 7. List all places where you have taken vacation for the past five years outside of Massachusetts: When Where Any Contact With Police 28

29 8. List all occasions where the police have been at your residence: When Reason Outcome 9. What is your Massachusetts auto insurance rating? IT IS UNLAWFUL IN MASSACHUSETTS TO REQUIRE OR ADMINISTER A LIE DETECTOR TEST AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW SHALL BE SUBJECT TO CRIMINAL PENALTIES AND CIVIL LIABILITY. Thank you for completing this application and your interest in employment with the Weymouth Police Department. 29

30 PLEASE READ THE FOLLOWING CAREFULLY AND SIGN BELOW INDICATING THAT YOU UNDERSTAND AND AGREE TO THE TERMS AS STATED. I understand that a physical, which includes a drug screening urinalysis, may be required after an employment offer has been made. I understand that this is not a contract of employment and I or the municipality may sever the employment relationship at anytime for any reason. Any oral or written statement to the contrary, including any which are made by a City/Town representative, are disavowed and may not be relied upon by any prospective or existing employee. I understand also that this Department has established day and night tours for which I must be available as required. I further understand that any appointment tendered me will be contingent upon the results of a complete character and fitness investigation, and I am aware that willfully withholding information or making false statements on this application will be a basis for rejection of my application or dismissal from the department. I agree to these conditions and I hereby certify that all statements made by me on this application are true and complete to the best of my knowledge. I hereby give the Weymouth Police Department authorization to contact any person reasonably related to the character and fitness investigation and to request that an independent credit report be prepared as to my financial condition. I also authorize any person contacted to share written and oral information which is reasonably related to the public safety position for which I am applying. Finally, I hereby release, discharge and exonerate this municipality, its agents and representatives, and any person furnishing or receiving information, from any and all liability of every nature and kind arising out of the furnishing or inspection of such documents, records, or other information or investigations made by or on behalf of this municipality. This authority shall continue until revoked in writing by the undersigned. Date Signature of Applicant Commonwealth of Massachusetts, SS. I,, being duly sworn, depose and state I am the above named person. I signed the foregoing statement. I personally read and printed by hand or typewriter / printer answer to each and every question therein and I do solemnly swear that each and every answer is full, true and correct in every respect. Sworn before me this day of, 20. Signature of Applicant Notary Public M Commission Expires: 30

31 GENERAL RELEASE Date: I,, born at on, having filed an application for employment with the Weymouth Police Department, consent to have an investigation made as to my moral character, reputation and fitness for the position to which I have applied. I also agree that such information as may be received, reported to and reviewed by the appointing authority. I agree to give any further information which may be required in reference to my past record. I also authorize and request every person, firm, company, corporation, governmental agency, court, association or institution having control of any documents, records and other information pertaining to me, to furnish to the Police Department any such information, including, documents, records, files regarding charges or complaints filed against me, formal or informal, pending or closed, or any other pertinent data, and to permit the police department or any of its agents or representatives to inspect and make copies of such documents, records and other information. Specifically, in addition, I hereby authorize the release of the following data or records to the Police Department: I hereby release, discharge and exonerate the Police Department, its agents and representatives and any person so furnishing information from any and all liability of every nature and kind arising out of the furnishing or inspection of such documents, records and other information or the investigations made by or on behalf of the Police Department. This authority shall continue for one year unless sooner revoked in writing by the undersigned. Signed Witness Address 31

32 CREDIT CHECK AUTHORIZATION The undersigned applicant certifies that he/she has duly authorized this credit check, and he/she acknowledges that all information requested is for the exclusive, official use of the undersigned police department and for use only in connection with such investigation; and the consumer report requested is for permissible purpose under the Fair Credit Reporting Act, of which the undersigned is knowledgeable. Pursuant to the provisions of the Fair Credit Reporting Act, an person who knowingly and willfully obtains information from a consumer reporting agency under false pretenses shall be fined not more than $5, or imprisoned for not more than one year, or both. Applicant Police Department Employee Requesting This Report Title Police Department Requesting Check 32

33 CORI CHECK ACKNOWLEDGMENT I, residing at Acknowledge that a Criminal Offender Record Information (CORI) check will be performed as part of the municipality s hiring process. I further acknowledge that a refusal to allow the CORI check to be performed will cause my application to no longer be considered for employment. Signature 33

34 NOTICE TO POLICE OFFICER AND FIRE FIGHTER CANDIDATES PENSION REFORM Please be advised that once established you must meet Medical and Physical Fitness Standards while employed in order to maintain your employment. Every two (2) years, you will be required to undergo a medical and physical fitness assessment. This assessment will consist of job related physical fitness test designed to simulate the physical demands of the duties that may be performed by a police officer or fire fighters, and an assessment of your overall medical condition as it relates to your ability to perform essential functions of your job. In order to assist you in meeting these standards, wellness programs will be made available to you that will provide you with information on maintaining your physical fitness and overall health and provide an assessment of key health indicators such as blood pressure and cholesterol levels. These standards are mandated by the provisions of Section 22D of Chapter 32 of the Massachusetts General Laws, as amended by Chapter 697 of the Acts of

35 NOTICE TO POLICE OFFICER AND FIRE FIGHTER CANDIDATES Please be advised that, in accordance with the provisions of Chapter 697, Section 117 of the Acts of 1987, no person who smokes tobacco products shall be eligible for appointment as a Police Officer or Fire Fighter from any Civil Service eligible list established after the effective date of this act, and no person appointed shall continue in such office or position if such person thereafter smokes any tobacco products. 35

36 Name: Social Security #: Date: Date of Birth: Address: Please explain what knowledge, skills and attitudes you think a police officer should possess. 36

37 Name: Social Security #: Date: Date of Birth: Address: Please explain how community policing benefits the police department, police officers and the community of Weymouth. 37