Correctional Officer
Application for Employment
Washington County
Human Resources Department
100 West Beau Street, Suite 202
Washington, PA 15301

Today's Date

Name*

Home Street Address*

City*

State

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Zip

Washington County Resident?

Yes

No

Home Phone

Previously Employed By Us?

Yes

No

Cell Phone

Would You Accept

Full Time Part Time

Temporary Per Diem

Have you been convicted of any crime, excluding summary traffic offenses?*

Yes

No

(Conviction will not necessarily preclude employment)

If yes, explain:

Date You Would Be Available For Work

How Did You Hear About Us?

Web Site Newspaper Friend Indeed Web Site Other

Are you willing to travel if your job requires it?

Yes

No

PA License

Positions Applied*

Any FT Registered Nurse RN Supervisor Deputy Sheriff Correctional Officer Secretary Court Technologist Crime Victim Advocate Enforcement Officer FITS Lead Foreman Administrative Assistant Site Monitor Program Monitor MDJ Clerk Booking Center Monitor Law Clerk Probation Officer Network Technician

Computer Programs

Other skills or certifications

WPM:

Professional, Business or Civic Activities

Have you ever served in the U.S. Armed Forces?

Yes

No

Branch of Service

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