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Phone:
614-491-1080
Address:
4175 Alum Creek Drive • Obetz, Ohio, 43207
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614-491-1080
4175 Alum Creek Drive • Obetz, Ohio, 43207
Applicants’ Employment Information Report
OPD – Applicants’ Employment Information Report
Person providing the below information
(Required)
First
Last
Applicant Name
(Required)
First
Last
Would the applicant able to take a human life?
(Required)
Yes
No
Unknown
Is the applicant able to work without supervision?
(Required)
Yes
No
Unknown
Would the applicant be able to work as a one officer car after training?
(Required)
Yes
No
Unknown
Would you recommend the applicant to be a police officer?
(Required)
Yes
No
Employment History
Employed From
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MM slash DD slash YYYY
Employed To
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MM slash DD slash YYYY
Employment Type
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Part-time
Full-time
Other
Title or Duty
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If not presently employed by you, indicate the manner of leaving your employment.
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Resigned Voluntarily
Requested to Resign
Discharged
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State reason for above
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Employee Performance
Cooperation
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Trouble Maker
Has difficulty
Cooperative
Gets along well
Excellent relations
Quality of Work
(Required)
Inferior Work
Careless
Meets requirements
Highly accurate
Exceptional
Dependability
(Required)
Needs supervision
Frequent checking
Usually dependable
Seldom checking
Highly reliable
Initiative
(Required)
Lazy, indifferent
Needs pushing
Adequate
Considerable
Highly motivated
Judgement
(Required)
Disorganized
Limited judgement
Plans well
Logical thinker
Creative
Quantity of work
(Required)
Slow
Insufficient
Moderate
Rapid worker
Highly productive
Tardiness?
(Required)
Yes
No
Absenteeism?
(Required)
Yes
No
Average Annual Tardiness
Average Annual Absences
Applicant available for re-hire?
(Required)
Yes
No
Able to follow orders?
(Required)
Yes
No
Polygraph / CVSA administered?
(Required)
Yes
No
Any discipline action on file?
(Required)
Yes
No
Would you prefer a personal interview?
(Required)
Yes
No
Your Phone Number
(Required)
Any additional comments?
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