To complete this section, begin with your present or more recent employer first, and continue in reverse chronological order.
List any traffic convictions for the last five years.
List any traffic crashes for the last five years.
In 150-300 words, describe why you want to enter the field of law enforcement
I respectfully request that you forward to the Town of Normal, Illinois, any and all information that you have concerning me, my work record, or my reputation. This includes any information that may appear in my personnel file, criminal conviction records, or other confidential files or records. This information will be used to determine my qualifications and fitness for the position of Intern I am seeking with the Town of Normal. I hereby release you and/or your employer from any liability and/or damage of whatever nature due to the furnishing of such information requested above. Further, I acknowledge that the internship program typically involves riding in agency vehicles and participating in policing activities. I realize that such activity involves risk of personal injury or property damage, and I hereby assume such risk and release and agree to hold harmless the Town of Normal, the Normal Police Department, their officers, agents and employees from any liability for civil damages arising out of their actions or the actions of others in connection with this activity. In consideration of participating in the ride-a-long program, I further covenant and agree, as a condition of the granting of my internship request, to indemnify and hold harmless the Town or Normal, the Normal Police Department, their officers, agents and employees from any liability which may be incurred by them or either of them proximately resulting from any acts or omissions by me during this activity. I further represent that I am above the age of 18 years, with full understanding of all risks involved and agree that this release and its indemnity agreement shall be binding upon my heirs, executors, administrators, and assigns. A copy of this release is as valid as the original signed REFERENCE RELEASE OF LIABILITY even though the copy does not have my original signature.
By my electronic signature, I certify that I have read and understand the Reference Release of Liability.
I hereby certify that all answers to the above questions are true and I agree and understand that any false statement contained in this application may cause rejection of this application or termination of internship, and shall constitute gross misconduct for benefit eligibility. I understand that an incomplete application may result in a lost internship opportunity. I authorize the Town of Normal to contact my current and past employers and personnel references listed above to verify employment, work records, and suitability for internship with the Town, and to investigate personal, criminal, or other areas, such as personal contact with neighbors, friends, or others with whom I am acquainted. This inquiry includes information as to my character, general reputation, personal characteristics, and mode of living. I understand that my appointment to an internship may be subject to satisfactorily completing a pre-employment medical exam, including drug and alcohol screen, and that the truthfulness of the statements in this application may be verified by polygraph examination. I understand that I will have to provide acceptable documentation attesting that I am a U.S. citizen. I understand that this application is not a contract of internship. I understand that any oral or written statement to the contrary is expressly disavowed, and should not be relied upon by my prospective or existing employee.
By my electronic Signature, I certify that I have read and understand the statements above.
Please read the Internship Rules as stated on http://www.normal.org/699/Internship.
By my electronic signature, I certify that I have read and understand the Internship Rules.
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