City Application Clive Police Department Civil Service Packet 2017 Clive Police Department Applicant Check List Background/Polygraph Consent Wavier Release of Information Waiver (Obtain Records) Police Department Personal History Statement Physical Agility Testing Consent Wavier Release of Information Consent Wavier (Candidate) Credit History Consent Waiver How did you learn about this position? Driving Record Authorization Form Photo Copy of Driver s License Photo Copy of High School Transcript/Diploma Photo Copy of Transcript of Higher Education attended (College/University) Photo Copy of Military Discharge/Separation Papers Personal Resume Copy of Birth Certificate Check off and turn this sheet in with your forms 1
CLIVE CIVIL SERVICE COMMISSION CERTIFICATION STANDARDS 1. To apply for a position as a police officer for the Clive Police Department, applicants must complete the Application Forms provided by the City of Clive and all forms provided with the application. Applicants must also submit a copy of a personal resume. Copies of the applicant's Birth Certificate, and grade transcripts called for in the application may be submitted after submission of the application, but these items must be supplied as soon as possible and not later than the day of the candidate's oral interview with the Commission. All answers to questions on the application must be true and accurate. Any false statements in the application will mean immediate disqualification of the applicant and shall also constitute grounds for immediate dismissal should the applicant be hired. The following forms must be completed and returned to the Clive Police Department with the application: City of Clive Application for Employment, Clive Police Department Personal History Statement Form, Personal Resume, Photocopy of Driver's license, and Forms CS-3, CS-4, CS-1O, CS-11, and CS- 13. 2. Applicants must agree to and complete letters authorizing the Clive Civil Service Commission and the Clive Police Department to conduct a thorough and complete background, scholastic, financial, and (post offer) medical investigation as well as a polygraph examination. Certification and appointment will also be subject to the applicant's successful completion of the Iowa Law Enforcement Academy's course within eighteen (18) months of appointment if not previously certified. 3. All applicants shall be judged for the position applied for based on the job description adopted by the City of Clive, the Clive Civil Service Commission's Procedures, and any applicable Clive City Ordinances. 4. Applicants will not be considered unless they meet the following minimum requirements: a) That he/she is a citizen of the United States of America; b) That upon employment, he/she will reside within thirty miles/thirty minute travel time of the Clive Police Department headquarters. c) That he/she is at least twenty-one years of age; d) That he/she currently holds a valid Driver's or Chauffeur's License and will have and hold a valid Iowa Driver's or Chauffeur's License prior to any final appointment; A photocopy of the applicant's current driver's license shall be submitted with other application materials. e) That he/she is not addicted to drugs or alcohol; f) That he/she be of good moral character as determined by a thorough background investigation including a fingerprint search conducted of local, state and national 2
fingerprint files. That he/she has not been convicted of a felony or a crime involving moral turpitude. (Moral Turpitude is defined as an act of baseness, vileness, or depravity in the private and social duties which a person owes to another person, or to society in general, contrary to the accepted and customary rule of right and duty between person and person.) It is conduct that is contrary to justice, honesty or good morals. The following nonexclusive list of acts have been held by the Courts to involve moral turpitude: income tax evasion, perjury, or its subornation, theft, indecent exposure, sex crimes, conspiracy to commit a crime, defrauding the government and illegal drug sales. Various factors, however, may cause an offense which is generally not regarded as constituting moral turpitude to be regarded as such. For example, a record of a number of convictions for simple assault would involve moral turpitude, whereas a singular act would not); g) That he/she, by reason of conscience or belief, are not opposed to the use of force when appropriate and necessary to fulfill the duties of a Police Officer; h) That he/she be of a weight proportional to their height as deemed appropriate by the examining physician; i) That he/she be a high school graduate with a diploma or possess an equivalency certificate and are able to read and write the English language; j) That he/she have uncorrected vision of not less than 20/100 in each eye which is correctable to 20/20 and normal color vision (Normal color vision, as determined by the American Optical Company, Pseudo-Isochromatic Plates test, requires correct identification of ten out of the fourteen plates); k) That he/she have normal hearing ability in each ear. (Hearing is considered normal when, tested by an audiometer, hearing sensitivity thresholds are within 2000Hz, and 3000Hz averaged together); tested by an audiometer, 25db measured at 1000Hz, l) That he/she be free from any physical, emotional or mental condition, which would render him/her of performing the essential functions of duty as determined by a physician. m) That he/she attain a satisfactory grade in a pre-employment written test, the National Police Officer Selection Test, (POST) as prescribed by the Iowa Law Enforcement Academy; n) That he/she have been tested, by the use of testing instruments approved by the Iowa Law Enforcement Academy to determine the possession of personality characteristics and suitability of an applicant for a law enforcement career; and o) That he/she attain a passing grade in the physical agility test developed by the Iowa Law Enforcement Academy. 5. With the exception of a consumer report obtained pursuant to the Fair Credit Reporting Act, no information regarding the applicant obtained by the Clive Civil Service Commission or the Clive Police Department as part of the application, examination or investigation process shall be released to the applicant or any representative of the applicant. 3
CLIVE CIVIL SERVICE COMMISSION EXAMINATION AND CERTIFICATION RULES 1. Completed applications must be returned to the Clive Police Department no later than 5:00 P.M., Friday, August 25, or, if mailed, postmarked no later than Friday, August 25. When returning the application packet in person the applicant will be fingerprinted and photographed at that time. 2. The Physical Agility test will be administered at a place and time to be determined. Candidates will be notified by email where and when to report. This test will be administered according to the standards and protocol set forth in the physical performance manual prepared by the Iowa Law Enforcement Academy (which may be reviewed at their web site). This test is given in four sections, each of which must be satisfactorily completed in order to obtain a passing grade. Each section of the test is adjusted for age and gender and consists of: a)the Sit and Reach Test, which measures the flexibility of the applicants lower back and upper leg area; b) The 1 Minute Sit Up Test, the score is based upon the number of bent leg sit-ups performed in 1 minute; c) The 1 Minute Push Up Test, the score is calculated by the number of push-ups performed in 1 minute; and d) The 1.5 Mile Run, the score is based upon the minutes and seconds needed to complete the run. All applicants must pass the minimum standards for each section of the physical agility test as determined by the Iowa Law Enforcement Academy. An applicant failing to pass any portion of the physical agility test will no longer be considered for employment during this testing period. All applicants must participate in the physical agility testing unless excused in advance for good reason with the approval of the Chief of Police. Transfer scores from another police agency will be accepted if completed within the previous six months and only with valid documentation of scores from the administering police agency. It is the responsibility of each applicant to be physically prepared to participate in the physical agility test and to wear the proper athletic clothing and running shoes to the test site. 3. Applicants passing all phases of the physical agility test shall be given a written examination, Standard and Associates, National Police Officer Selection Test (POST) at a place and time to be determined. Candidates will be notified by email where and when to report. The examination will be administered by the Clive Civil Service Commission. Applicants must bring a valid driver's license with them to the testing site. The POST test covers four areas of desired abilities, math, reading comprehension, grammar, and incident report writing. An applicant who has taken and passed the POST test within the previous six months will be allowed to repeat the test, or may have their previous score accepted and considered along with other applicants who pass the test. An applicant must have a score of at least 70% on each of the four sections of the test to have a passing score. The test has a total of 75 questions and a total time limit of 83 minutes. The written POST test will then be scored and posted by approximately 12 PM, Noon on the following Monday. The top 30 passing scores, including ties for 30th place, will then proceed to the next phase of the applicant testing process. Those applicants failing the test or who pass but fail to place in the top 30, will not be considered further during this testing period. Applicants who have previously taken and 4
passed the written POST test within the previous six months will have their score compared against other passing scores, and must place among the top 30 written test scores to be considered further. 4. Any violation of testing procedures shall result in a disqualification of the applicant. 5. A detailed background investigation will be conducted on each applicant successfully passing the written POST test and physical agility test. The background investigation will be conducted through interviews of references, teachers, past and present employers, co-workers, acquaintances, neighbors, and other associations. A credit report on the applicant's financial stability may also be requested. The application submitted by each candidate will be checked for accuracy, omissions, and falsifications. Any omissions or false statements of fact in the application may result in disqualification and may be grounds for immediate dismissal if discovered following the appointment of an applicant. A criminal history and driving record check will be performed on each applicant. Fingerprints of each applicant will be submitted to the Iowa Division of Criminal Investigation (DCI) and the Federal Bureau of Investigation (FBI) as part of a criminal records check. Any applicant who posts on a social media account must permit to having that account accessed as part of the background investigation. 6. A polygraph examination will be administered to each applicant that passes the background investigation, the POST written test and the physical agility test. A previously passed polygraph examination may be considered for this requirement. 7. Applicants passing the written examination, physical agility test, and polygraph examination will be given an oral examination before the Commission relating to general background of the applicant, the applicant's work experience, general knowledge, demeanor, and ability to communicate verbally. Any false statement of fact shall result in disqualification of the applicant and will be grounds for immediate dismissal if discovered following the appointment of an applicant. 8. Following the written examination, the physical agility test, the background investigation, the polygraph examination, and the oral examination, all applicants with passing scores will be graded and ranked in accordance with paragraph 10 below. Those applicants with a passing grade will be ranked one through ten and will then be certified to the Clive City Council as eligible for appointment as Clive Police Officers subject to: 1) successfully passing a detailed medical physical examination and 2) attaining a satisfactory score on the Minnesota Multiphasic Personality Inventory, (MMPI) a psychological test. 9. The applicant's application will be subject to a detailed examination by the Commission. Any false statement of fact in the application may result in disqualification and may be grounds for immediate dismissal if discovered following the appointment of an applicant. 10. Applicants will be graded and ranked according to the following procedures: (a) Forty percent of the grade will consist of the score achieved on the written examination (b) Forty percent of the grade will consist of the individual board member s combined evaluation of the applicant s oral examination 5
(c) Twenty percent of the grade will consist of the individual board members' evaluation of the applicant's background and previous work experience. A combined grade of seventy percent shall be considered a passing grade. Ranking will be based on the combined grades. 11. Applicants claiming a Veterans Preference are required to provide a discharge and/or full-sized photo copy of service record with their application 12. Candidates meeting the requirements of Chapter 400.10 of the Code of Iowa qualifying for veterans preference shall have five (5) points added to their score attained in the qualifying examinations and an additional five (5) points if the veteran has a service connected disability. However the points shall be given only upon passing the exam and shall not be the determining factor in passing. 6
CLIVE CIVIL SERVICE COMMISSION I hereby consent to a background investigation, which I know to be necessary for my consideration by the Clive Civil Service Commission. I further specifically consent to a polygraph examination. I also hereby consent to a post-offer and pre placement inquiry into my physical and mental condition. With the exception of any rights to which I am entitled under the Fair Credit Reporting Act, and which have been explained to me in a separate notice and consent, I hereby waive any and all rights I may now or hereafter possess to obtain, review or copy all, or any part, of such information, opinion or assistance, or any other information or document obtained by the Clive Civil Service Commission or the Clive Police Department pursuant to this consent. I am familiar with the physical agility test required and know of no reason why I should not undertake the task of passing that test and I relieve the Commission, the City of Clive and the test administrators of any and all liability of any nature based upon any injury sustained by me as a result of my taking the physical agility test. I understand that it is my own obligation and responsibility to discontinue any test including the physical agility test, when necessary or helpful to protect my health or well-being, and I hereby release the Clive Civil Service Commission, the City, its officers and agents from any and all liability or responsibility in this respect. I further request that the Clive Civil Service Commission evaluate my competency in a closed session when the Commission deems it necessary to do so to prevent needless and irreparable injury to my reputation. Dated this day of, 20 Applicant Name Printed Witness Applicant Signature 7
TO WHOM IT MAY CONCERN: I am a candidate for appointment to the Clive Police Department. This is your full and sufficient authority to give any representative of the Clive Police Department or Clive Civil Service Commission, as requested, any information, opinion or assistance about reports or records of the undersigned or any other information or documents that you may have in your custody or under your control, with reference to me. It is my intent that the foregoing shall apply to any doctor or hospital; psychologist; educational institution or school; savings, banking or lending institution; governmental body; or any other person or organization which may have information in its possession concerning my character, education, physical or medical condition, psychological condition, or financial responsibility regardless of its nature. I hereby release for every person or entity providing such information, opinion or assistance from any and all liability providing the same. A photocopy, or exact reproduction of this authorization, as duly executed, shall have the same force and effect as this original. Dated this day of, 20 Applicant Name Printed Witness Applicant Signature 8
RELEASE In consideration for receiving permission from the Clive Civil Service Commission to participate in the Civil Service examinations and be evaluated for the position of Clive Police Officer and in further consideration of receiving permission to participate in the physical agility test associated therewith, receipt of such permission being also hereby acknowledged, I hereby release the Clive Civil Service Commission, the City of Clive, and their agents, officers, servants and employees, of and from any and all liability, claims, demands, actions, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained (whether or not due to the negligence of the Clive Civil Service Commission, City of Clive, or its agents, officers, servants or employees) or any property that belongs to me, while in, on, or upon the premises at which the physical agility test is being conducted, or in route to or from these premises, or any other premises under the control or supervision of the Clive Civil Service Commission, the City of Clive, or facilities being used by the City of Clive. I, being duly aware of the risks and hazards inherent upon participating in the physical agility test and having been given the opportunity to personally inspect all testing devices and the testing program, hereby elect voluntarily to participate in the physical agility test knowing the present conditions existing and knowing that said conditions may become more hazardous and dangerous during the time that I am engaged in said examination. I hereby voluntarily assume all risks of loss, damage, injury, including death, that I may sustain or any property while engaged in said examination, or upon said premises. This release shall be binding upon the distributee, heirs, next of kin, executors and administrators of each of the undersigned. I further state that I am capable of undertaking this examination without endangering my health or safety and understand my own obligation to discontinue any testing phase when necessary to protect my own well-being. In signing the foregoing release, I hereby acknowledge and represent: A. That I have read the foregoing release, understands it and signs it voluntarily; and B. That I am 21 years of age or older and of sound mind. Dated this day of, 20 Applicant Name Printed Applicant Signature 9
WAIVER FOR RELEASE OF INFORMATION TO WHOM IT MAY CONCERN: I,, do hereby authorize a review of and full disclosure of all testing results or data, whether public or confidential in nature, accumulated as a result of mandated testing, concerning my qualifications to be a law enforcement officer. I understand that such information will be accessible to The City of Clive, The Clive Civil Service Commission, and law enforcement agencies, or their designees, for employment purposes only, and do hereby consent to its dissemination. I further consent to the utilization of the mandated testing data or test results by The City of Clive, The Clive Civil Service Commission, and the Iowa Law Enforcement Academy, or their designees, for purposes of educational or scientific research. I certify that any person(s) or entities who may furnish information concerning my mandated test data or test results shall not be held accountable for releasing this information; and I do hereby release said person(s) and entities from any and all liability for damage of whatever kind which may at any time result to me, my heirs, and family or associates because of compliance with this waiver and release of information, or any attempt to comply with it. I further release The City of Clive, the Clive Civil Service Commission and the State of Iowa, the Iowa Law Enforcement Academy, and their designees individually or collectively from any and all liability for damage of whatever kind which may at any time result to me, my heirs, and family or associate because of compliance with this waiver and release of information, or any attempt to comply with it. FULL NAME SIGN NAME DATE CURRENT ADDRESS WITNESSED THIS DAY OF, 20 SIGN NAME, WITNESS ( ) PHONE NUMBER, WITNESS PRINT NAME, WITNESS CURRENT ADDRESS, WITNESS 10
NOTICE TO APPLICANTS THE PHYSICAL AGILITY TEST WILL BE ADMINISTERED. THOSE PASSING THE PHYSICAL AGILITY TEST WILL TAKE THE WRITTEN POLICE OFFICER EXAMINATION (POST TEST. IT IS IMPORTANT THAT YOU BRING OR WEAR THE PROPER APPAREL FOR THE PHYSICAL AGILITY TEST, SUCH AS RUNNING SHOES, SHORTS, T-SHIRT, SWEAT CLOTHES, ETC., THAT WOULD BE APPROPRIATE FOR STRENUOUS PHYSICAL ACTIVITY AND THE TESTING ENVIRONMENT. IT IS YOUR RESPONSIBILITY TO BE PHYSICALLY FIT TO PERFORM THE PHYSICAL AGILITY TEST. THE WRITTEN POLICE OFFICER EXAMINATION, WILL BE ADMINISTERED AT A DATE & TIME TO BE DETERMINED IN THE COMMUNITY ROOM OF THE DYMOND PUBLIC SAFETY CENTER, 8505 HARBACH BLVD., THE TEST WILL BE SCORED AND THE TOP THIRTY APPLICANT SCORES, INCLUDING TIES, WILL BE POSTED. ALL APPLICANTS WILL BE PHOTOGRAPHED AND FINGERPRINTED UPON FILING AN APPLICATION WITH THE POLICE DEPARTMENT. THIS MUST BE COMPLETED AT THE CLIVE POLICE STATION. IF THE APPLICATION IS MAILED, ARRANGEMENTS WILL HAVE TO BE MADE BY APPLICANTS TO HAVE THEIR FINGERPRINTING DONE EITHER PRIOR TO WRITTEN EXAMINATION OR ON THE DAY OF THE EXAM. PROPOSED TIME LINE TO DEVELOP A CERTIFIED CIVIL SERVICE LIST. August 25, 2017 CUT OFF DATE FOR ACCEPTING COMPLETED APPLICATIONS September, 2017 PHYSICAL AGILITY TEST AND WRITTEN POST EXAM October, 2017 November 2017 November 2017 December, 2017 CRIMINAL HISTORY CHECKS, POLYGRAPH EXAMINATIONS, ETC. CIVIL SERVICE INTERVIEWS CERTIFIED CIVIL SERVICE LIST ESTABLISHED CERTIFIED CIVIL SERVICE LIST TO CLIVE CITY COUNCIL FOR APPROVAL 11
FAIR CREDIT REPORTING ACT NOTICE TO EMPLOYEE This is to advise you that for employment purposes, and once we have received your written consent, the City of Clive may obtain various consumer reports about you from one or more consumer reporting agencies. A consumer report, including a credit history report, may also include information regarding your character, general reputation, personal characteristics and mode of living, and is used to determine your eligibility for employment. In the event any adverse action is taken against you based in whole or in part on the consumer report, the City of Clive will first provide you with a copy of your consumer report and a full description of your rights under the Fair Credit Reporting Act, 15 U.S.C. 1681a, et seq. Under the Federal Fair Credit Reporting Act, you have the right to ask for complete and accurate disclosure of the nature and scope of the consumer report we may request on you. Your request for this additional disclosure must be: (1) in writing and made within a reasonable time period after you receive this notice; and (2) sent to the Clive City Manager, Dennis Henderson. The City will send you the additional disclosure within five days from the date we receive your written request or five days after the date we first request the consumer report on you, whichever is later. CONSENT TO OBTAIN CONSUMER REPORT The undersigned, and applicant for employment with the City of Clive Police Department, hereby acknowledges that I have read the notice informing me that the City may obtain a consumer report on me for employment purposes. I understand that I have a right to request additional disclosures concerning the nature of the report, and that if the report is used to take any adverse action against me, I will be provided a copy of the report and a full description of my rights under the Fair Credit Reporting Act. I authorize the City and give it my consent to order a consumer report on me, if needed. I consent to the City s use of such reports for employment purposes. Date: Signature: Printed Name: 12
CITY OF CLIVE Driving Record Authorization Form I authorize the City of Clive to obtain my motor vehicle driving record no less than annually. I understand this is a requirement for use of private and city-owned transportation to fulfill the job requirements of employment by the city. Date of Birth First Name Middle Name Last Name Driver s License Number (As it appears on Driver s Li cense) License Expiration Date Employee Signature Date Signed 13
How did You Learn about This Job Opening? Applicant Name Date How did you first learn about this job opening? Please choose and circle only one. 1. Newspaper ad (if so, name of publication) 2. Employment Website (discover policing, monster, etc.) 3. City of Clive/Clive Police Website 4. College or University (if so, name of institution) 5. Social Media 6. Clive Police Department Employee(name of employee) 7. Other (please list) 14