Chandler Police Department Background

Summary

NAME:____________________________________
Last First Middle
DATE:__________________
POSITION SOUGHT: ____________________________
CHANDLER POLICE
DEPARTMENT
Background Questionnaire
FOLLOW DIRECTIONS CAREFULLY
1. WRITE LEGIBLY IN YOUR OWN HANDWRITING OR PRINTING

2. USE BLACK INK TO COMPLETE QUESTIONNAIRE

3. READ EACH QUESTION CAREFULLY BEFORE ANSWERING IT

4. ANSWER ALL QUESTIONS COMPLETELY AND ACCURATELY

5. IF A QUESTION DOES NOT APPLY, WRITE “N/A” IN THE SPACE
PROVIDED

6. IF YOU NEED ADDITIONAL SPACE, MAKE A COPY OF THE
“FURTHER EXPLANATIONS” SHEET, UNLESS OTHERWISE
DIRECTED (Sections B and C)
7. SIGN THE QUESTIONNAIRE AND HAVE IT NOTARIZED. THE
POLICE DEPARTMENT WILL NOT NOTARIZE YOUR
SIGNATURE

8. AFTER COMPLETING THIS PACKET, BRING IT WITH YOU TO YOUR
FIRST INTERVIEW

REMEMBER THAT ANY OMISSION, DECEPTION, OR FAILURE TO
FOLLOW THE INSTRUCTIONS GIVEN IN FILLING OUT YOUR PACKET
COULD DELAY OR DISQUALIFY YOUR APPLICATION OR YOU FROM
FURTHER CONSIDERATION

Chandler Police Department
Professional Standards Section
Mailing: Mail Stop 303, PO Box 4008
Chandler, AZ 85244-4008
Location: 250 E. Chicago St

Chandler, AZ 85225
t:\Sworn BG Packet 2013.doc
Background Packet
(Table of Contents)
Personal Data…………………………………………………………..Pg. 5-6
Former Residences…………………………………………………….Pg. 7
Employment History…………………………………………………..Pg. 8-12
References……………………………………………………………...Pg. 13
Education/Training……………………………………………………Pg. 14
Arrest/Legal History…………………………………………………..Pg. 15-20
Driving History………………………………………………………..Pg. 21-22
Alcohol/Drug History…………………………………………………Pg. 23-26
Military………………………………………………………………...Pg. 27-28
Financial Status……………………………………………… ……….Pg. 29-30
Social Networking………………………………………………….….Pg. 31
Law Enforcement Experience………………………………….…….Pg. 32-34
Prior Police Applications………………………………….…….…….Pg. 35
General Questions………………………………………….…….……Pg. 36
Summary Statement………………………………………….…..……Pg. 37
Certification/Disclosure…………………………………….….….…..Pg. 38
Reminder/Checklist………………………………………….…..….…Pg. 39
Further Explanation Form………………………………….…...……Pg. 40
Table of Contents 2
Chandler Police Department DATE:________________
POSITION_______________________________________________________________________
SWORN DETENTION RESERVE CIVILIAN VOLUNTEER
This questionnaire will be used for reference by those who will be considering you for employment or for a commission
with the CHANDLER POLICE DEPARTMENT

An extensive background investigation will be conducted into your personal history

Applicants will be required to take a polygraph examination (1) to confirm the information in this questionnaire and (2) to
determine other items of background information

I understand that I will not receive, and I am not entitled to, a copy of the report or to know its contents. I further
understand that the contents will be used in the evaluation process for employment with the City of Chandler and that no
documents submitted by me will be returned, and no copies of any other reports or documents utilized for or during my
application for employment or a commission will be furnished or given to me. Unless I am not selected for employment
based on a single test, I WILL NOT BE ADVISED OF THE REASONS FOR NON-SELECTION

Where written explanations are required in this form, it is MANDATORY that the information be listed TOTALLY
AND COMPLETELY

The existence of any of the conditions listed below may result in rejection from the selection process. These areas will be
explored during an extensive background investigation and psychological and polygraph examinations

NOTE: Appropriate business attire is required for all steps of your processing, including all interviews, polygraph
examinations, psychological evaluations, and employee orientations. Failure to comply may result in
removal from the hiring process

CRITERIA STANDARDS FOR DISQUALIFICATION
1. ANY FELONY CONVICTION (NO TIME LIMIT)
2. PARTICIPATION IN ANY SERIOUS CRIME
3. ANY MISDEMEANOR CONVICTION INVOLVING NARCOTIC DRUGS, DANGEROUS DRUGS OR
MARIJUANA
4. ANY SELLING OF NARCOTICS DRUGS, DANGEROUS DRUGS OR MARIJUANA
5. ANY RECENT ILLEGAL USE OF MARIJUANA
6. ANY EXCESSIVE ILLEGAL USE OF MARIJUANA IN YOUR LIFE
7. ANY RECENT ILLEGAL USE OF NARCOTICS OR DANGEROUS DRUGS
8. ANY EXCESSIVE ILLEGAL USE OF NARCOTICS OR DANGEROUS DRUGS IN YOUR LIFE
9. NEGLIGENCE IN MAINTAINING FINANCIAL RESPONSIBILITY
10. ANY HISTORY OF DISREGARD FOR TRAFFIC LAWS WITH SUCH FREQUENCY SO AS TO
INDICATE A DISRESPECT FOR TRAFFIC LAWS AND A DISREGARD FOR THE SAFETY OF OTHER
PERSONS ON THE HIGHWAY
11. ANY SEXUAL CONDUCT PROHIBITED BY LAW
PLEASE CONFIRM THAT YOU HAVE READ, UNDERSTAND, AND AGREE TO THE AFOREMENTIONED
CONDITIONS AND CRITERIA BY SIGNING BELOW

_____________________________________
Applicant Signature Date
Subscribed and sworn to before me this
_______ day of _____________________, 20 _____
My commission expires: ______________________
___________________________________________
Notary Public
Disqualifiers 3
Chandler Police Department
AUTHORITY FOR RELEASE OF INFORMATION
Last Name First Name Middle Name Sex Race Date of Birth SSN
City of Birth County State Country
I, _______________________________, do hereby authorize a review of and full disclosure of all records, or any part thereof, concerning
myself, by and to ANY duly authorized agent of the Chandler Police Department, Professional Standards Section, whether said records are of
public, private, or confidential nature

The intent of this authorization is to give my consent for full and complete disclosure of the records of educational institutions; financial or
credit institutions (including records of deposits, withdrawals, balances of checking and savings accounts, and loans) and also the records of
commercial or retail credit agencies (including credit reports and/or ratings); public utility companies; employment and pre-employment records,
including background reports, efficiency ratings, complaints or grievances filed by or against me, and salary records; real and personal property
tax statements and records, and other financial statements and records wherever filed; records of complaint, arrest, trial, and/or convictions for
alleged or actual violations of law, including criminal, civil, and/or traffic records; the results of any polygraph examinations; records of
complaints of a civil nature made by or against me, wherever located, including the records and recollections of attorneys at law, or of other
counsel, whether representing me or another person in any case in which I presently have or have had an interest

I reiterate and emphasize that the intent of this authorization is to provide full and unobstructed access to the background and history of my
personal life for the specific purpose of pursuing a background investigation, which may provide pertinent data for the Chandler Police
Department to consider in determining my suitability for employment by that department. It is my specific intent to provide access to personal
information, however personal or confidential it may appear to be, and the sources of information specifically identified herein

I understand that any information obtained by a personal history background investigation, which is developed directly or indirectly, in whole or
in part, upon this release authorization will be considered in determining my suitability for employment by the Chandler Police Department. I
understand that all materials pertaining to this background investigation become the property of the Chandler Police Department, Professional
Standards Section, and will not be returned to me

I agree to indemnify and hold harmless the person to whom this request is presented and his agents and employees, from and against all claims,
damages, losses, and expenses, including reasonable attorney’s fees, arising out of or by reason of complying with this request. I further
understand that in the event my application is disapproved, the sources of confidential information cannot be revealed to me

A photocopy of this release form will be valid as an original hereof, even though said photocopy does not contain an original writing of my
signature

MUST BE SIGNED IN THE PRESENCE OF A NOTARY:
Subscribed and sworn to before me this
_________ day of _____________________, 20_____. _________________________________________
Applicant Signature Date
My commission expires: ________________________
_________________________________________________
_____________________________________________ Street Address City State Zip
Notary Public
Release 4
Note: Where necessary, use a separate page to complete answers throughout this
questionnaire

A. Personal Data Today’s Date: _____________
Full Name: ____________________________________________________SSN_______________
LAST FIRST MIDDLE
AKA/Maiden Name _______________________________________________________________
DL # ______________Gender: _____ Marital Status ___________ Date of Birth: ______________
MM/DD/YY
Height ______ Weight _______ Eye Color __________ Hair Color __________ Race __________
Address: ________________________________________________________________________
NO./STREET APT. # CITY STATE ZIP
Phone: (_____) _______________ (_____) _________________ _________________________
HOME CONTACT EMAIL
1. Have you ever used or been known by any other name other than the one you listed on this
questionnaire (including your maiden name)? Yes No
If yes, list name(s): ____________________________________________________________
2. Have you ever used a social security number other that the one you have listed? Yes No
If yes, list number(s): _______________________
3. Have you ever taken a polygraph before? Yes No
If yes, when? (dates): ____________________________________________________________
Companies or agencies: __________________________________________________________
______________________________________________________________________________
Outcome of each test: ____________________________________________________________
______________________________________________________________________________
4. Have you ever committed a felony or an offense that would be a felony if committed in Arizona?
. Yes No
If yes, explain:
5. Have you driven a vehicle under the influence of alcohol in the past three years and not been
caught? Yes No
If yes, explain:
6. Have you ever failed to file an IRS statement? Yes No
If yes, list year(s): _______________ Why? _________________________________________
_____________________________________________________________________________
Personal Data 5
A. Personal Data Continued
7. Are you currently delinquent with any child support obligations? Yes No
If yes, explain:
8. Have you ever failed to make child support payments you were legally required to make?
Yes No
If yes, explain:
9. Do you have any prejudices against any group? Yes No
If yes, explain:
10. Have you ever had a physical confrontation (i.e. pushed, slapped, punched, etc.) with a
romantic/intimate partner (i.e. spouse, girlfriend/boyfriend, date)?
No Yes, on two or three occasion
Yes, on one occasion Yes, on four or more occasion
If yes, explain:
11. Have you ever been a member of any organization that advocates, advises, or supports the use
of force or other unlawful means to deny other person their rights under the constitution of the
United States? Yes No
If yes, explain:
12. Did you cheat, lie, or commit fraud in any way on your application or evaluation process for
this job? Yes No
If yes, explain:
13. Indicate whether you have been rejected as a job applicant for any of the following reasons:
a. Issues raised by a background investigation? Yes No N/A
b. Issues raised by a polygraph? Yes No N/A
c. Issues raised by an oral board? Yes No N/A
d. Issues raised by a physical agility test? Yes No N/A
e. Other __________________________
If yes, explain:
14. Have you ever failed to successfully complete a probationary period with a law enforcement
agency? Yes No
If yes, explain:
Personal Data 6
B. List all residence addresses, starting with the present and proceed backwards for
the past 10 years. Include school, military, and personal residences

ACCOUNT FOR ALL TIME. DO NOT LEAVE ANY TIMEFRAME BLANK

LIST EVERYTHING IN PROPER SEQUENCE. If you need additional space,
copy this page before completing, and attach copy as Page 6(a)

From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
From (MM/YY) To (MM/YY) Number and Street City State/County Zip Code
Residences 7
C. Employment History
List all places of employment. Begin with present or most recent employer and go backwards. List
periods of school, military service, and unemployment in the past 10 years. List everything in
proper sequence, leaving no vacant time lapse. Do not omit any employers. If you need
additional space, copy this page before completing, and attach copy as Page 8(a)

From (MM/YY) To (MM/YY) Job Title
Name of Employer Supervisor Ending Salary
Address of Employer Street, City, State, Zip Phone
Describe your duties:
Reason for leaving:
From (MM/YY) To (MM/YY) Job Title
Name of Employer Supervisor Ending Salary
Address of Employer Street, City, State Zip Phone
Describe your duties:
Reason for leaving:
From (MM/YY) To (MM/YY) Job Title
Name of Employer Supervisor Ending Salary
Address of Employer Street, City, State Zip Phone
Describe your duties:
Reason for leaving:
From (MM/YY) To (MM/YY) Job Title
Name of Employer Supervisor Ending Salary
Address of Employer Street, City, State Zip Phone
Describe your duties:
Reason for leaving:
Employment History 8
C. Employment History Continued
From (MM/YY) To (MM/YY) Job Title
Name of Employer Supervisor Ending Salary
Address of Employer Street, City, State Zip Phone
Describe your duties:
Reason for leaving:
From (MM/YY) To (MM/YY) Job Title
Name of Employer Supervisor Ending Salary
Address of Employer Street, City, State, Zip Phone
Describe your duties:
Reason for leaving:
From (MM/YY) To (MM/YY) Job Title
Name of Employer Supervisor Ending Salary
Address of Employer Street, City, State Zip Phone
Describe your duties:
Reason for leaving:
From (MM/YY) To (MM/YY) Job Title
Name of Employer Supervisor Ending Salary
Address of Employer Street, City, State Zip Phone
Describe your duties:
Reason for leaving:
Employment History 9
C. Employment History Continued
1. Have you ever been terminated or asked to resign from any employment? Yes No
If yes, complete the following:
Employer’s Name: ____________________________________ Phone: ________________
Explanation:
2. Have you ever resigned from a job to avoid being fired or terminated? Yes No
If yes, name of employer: ________________________________________________________
Explanation:
3. Are you currently employed? Yes No
4. If your work performance has been evaluated in the past, what is the latest evaluation you
received?
Exceptional
Above average
Average
Below average
Never been evaluated
5. Have you been tardy or late for work because of circumstances within your control?
Yes No
If yes, how often? _________________ Last time: __________________
Explanation:
6. During the past year, have you falsified sick time by calling in sick when you were not ill?
Yes No If yes, when? _____________________________________________________
Explanation:
7. Have you been unemployed anytime during the past three years? Yes No
If yes, when? __________________________________________________________________
Explanation:
Employment History 10
C. Employment History Continued
8. Have you ever been written up, counseled, or disciplined in any manner, by any of your
employers for failure to comply with required rules or regulations, or for any other reason?
Yes No
If yes, explain:
9. Have you ever been suspended or served an “Intent to terminate” by any employer?
Yes No
If yes, explain:
10. Have you ever quit a job without giving notice required by an employer? Yes No
If yes, explain:
11. Would you be eligible to be rehired by all your former employers (assuming there was a job
available)? Yes No
If no, explain:
12. Did you ever work without reporting it (even on the side) while collecting unemployment
benefits? Yes No
If yes, explain:
13. Have you ever taken merchandise or goods that you were not authorized to take from a
company where you worked?
No, never
Yes, items with a total value of less that $25
Yes, items with a total value of between $26 to $99
Yes, items with a total value of between $100 to $499
Yes, items with a total value of $500 or more
14. Have you ever taken money that you were not authorized to take from a company where you
have worked? Yes No
If yes, how much? ________
How many times? ________
Last time: ______________
Explanation:
Employment History 11
C. Employment History Continued
15. Have you ever purposely taken anything from a fellow employee that you were not authorized
to take? Yes No
If yes, what? _____________________________________When?_______________________
Explanation:
16. Have you ever taken anything from a job site or crime scene that you were not authorized to
take? Yes No
If yes, what? _____________________________________When?_______________________
Explanation:
17. While employed, have you ever been involved with another employee or outside person in a
scheme to defraud your employer? Yes No
If yes, explain:
18. Has an employer ever accused you of being dishonest? Yes No
If yes, explain:
19. Have you ever been bonded? Yes No
20. If yes, was it canceled? Yes No
If yes, explain:
21. Did you ever sell or give confidential information you received through your employment to
anyone for financial gain or for any other reason? Yes No
If yes, explain:
22. Have you ever or are you now making payments to any employer or bonding company for
merchandise taken, stolen, or lost? Yes No
If yes, explain:
Employment History 12

Background questionnaire follow directions carefully 1. write legibly in your own handwriting or printing. 2. use black ink to complete questionnaire. 3. read each question carefully before answering it. 4. answer all questions completely and accurately. 5. if a question does not apply, write “n/a” in the space provided . 6.

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Frequently Asked Questions

How many police officers does chandler az have?

The Chandler Police Department (CPD) employs 334 sworn officers and 171 civilians. CPD serves a growing population of close to 270,000 residents as of January 2021. The organization is divided into two divisions and one bureau.

What does the chandler police department do for crime prevention?

The Chandler Police Department currently has one crime prevention officer and one crime prevention specialist. We utilize the Crime Prevention Through Environmental Design (CPTED) best practice national model. They are highly trained in all areas of crime prevention including The Chandler Police Department has many resources for your use below.

Does the chandler police department have text messaging?

The Chandler Police Department recently deployed non-emergency text messaging capabilities in our communications center in an effort to provide our citizens with an alternative means to contact the department.