Answer all questions completely and accurately. Parts I-IV and VIII, marked with an asterisk, are required. Parts V-VII are not required but would be helpful. Volunteers assigned to certain areas or tasks, for example volunteer coordinator, may subsequently be required to submit additional information. If any question is unclear, contact Sgt. Jacob Hunt at (405) 307-7128 or email at Jacob.Hunt@NormanOK.gov.

I. *Name and address (required)

First name:

Last name:

Middle name:

Title:

Nickname:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

OK to call me here

Cell phone:

* OK to call me here

Email address:

Date of birth:

Gender:

Driver's license number:

Social Security Number:

II. *Personal References (required)

List one personal references. Exclude immediate family members or others listed in this application.

First name:

Last name:

Other phone:

* OK to call here

III. *Emergency Contact (required)

First name:

Last name:

Cell phone:

OK to call here

Other phone:

OK to call here

Relationship:

IV. A. *Legal History (required)

Have you ever been convicted of a felony or are you currently charged with the commission of a felony? If yes, state what, when, and how:

IV. B. *Legal History (required)

Have you ever been convicted of a misdemeanor violent offense? If yes, state what, when, and how:
(Examples include, but are not limited to: assault, battery, domestic violence, stalking, etc.)

IV. C. *Legal History (required)

Have you ever been convicted of a misdemeanor drug or alcohol offense? If yes, state what, when, and how:
(Examples include, but are not limited to: driving under the influence, simple drug possession, drunk and disorderly, public intoxication, possession of drug paraphernalia, etc.)

IV. D. *Legal History (required)

Have you ever been convicted of a misdemeanor weapons offense? If yes, state what, when, and how:

IV. E. *Legal History (required)

Have you ever been convicted of a misdemeanor theft offense? If yes, state what, when, and how:

IV. F. *Legal History (required)

Have you ever been convicted of a misdemeanor animal cruelty offense? If yes, state what, when, and how:

V. Residence History (helpful)

Begin with most recent and go back 5 years. Include address, city, state, and zip.

VI. Work History (helpful)

Begin with most recent, list your employer(s) by name and address for the last 5 years.

VII. Statement of Interest/History (helpful)

Please articulate your desire to participate in the intern or volunteer program with the Norman Police Department. Describe any current or previous volunteer work, including but not limited to experience working with animals. Please include your career goals if applicable.

VIII. *Authorization for Release (required)

By submitting this application, I certify that facts given in this application are true and complete to the best of my knowledge. I hereby grant permission to the City of Norman to investigate any information included in this application. I understand that this application is not a contract of employment. I hereby release the City of Norman and its agents from all liability in making any investigation or inquiry relative to any information contained in this application. I understand that false, misleading or incomplete information, given or implied, in this application or related interview may result in disqualification from the process or termination of my intern or volunteer status. I understand that I am required to abide by all applicable rules and regulations of the City of Norman, the Norman Police Department, and the Norman Animal Welfare Center.

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

I Agree