Official SealHuman Resource Services Department


#20-6108-01
Supplemental Questionnaire

Last Name
First Name
1.

IMPORTANT:  Applicants for this position are required to submit responses to the following supplemental questions. 

By selecting yes below, you certify your understanding that all applicants must meet minimum qualifications in order to move forward in the process.  Do you understand the above statement?

Yes No
2.

Do you possess a Bachelor's degree or higher from an accredited college or university (you have completed all requirements and have a graduation certificate conferred by Monday, March 30, 2020)?

Yes No
3.

Are you a citizen of the United States or have you applied for citizenship?

Yes, I am a citizen of the United States.
No, I am not a citizen of the United States.
No, I am not a citizen of the United States, but I have filed for citizenship at least one year before applying for Deputy Probation Officer I.
4.

Do you possess a valid California Driver's License?  (If yes, please ensure this information is indicated on your application).

Yes No
5.

Are you 21 or more years of age?

Yes No
6.

The following are some of the minimum peace officer selection standards set forth in Government Code Sections 1029 and 1031.  Every California peace officer must be:

  • Free of any felony convictions
  • Fingerprinted for purposes of search of local, state, and national fingerprint files to disclose any criminal record
  • Of good moral character, as determined by a thorough background investigation
  • Found to be free from any physical, emotional, or mental condition which might adversely affect the exercise of the powers of a peace officer

Did you read and understand these statements?

Yes No
7.

I understand that a thorough background investigation will be conducted on all prospective Deputy Probation Officer I candidates.

Yes No
8.

Are you on probation/parole?

Yes No
9.

Have you ever been the subject of an emergency protective order/restraining order/stay-away order?

Yes No
 

If yes, please provide the date the emergency protective order/restraining order/stay-away order was issued (mm/dd/yyyy).

If no, please enter "N/A".

10.

Have you ever fraudulently received welfare, unemployment compensation, workers’ compensation, or other state or federal assistance?

Yes No
 

If you answered yes, please give the date (mm/dd/yyyy).

If you answered no, please enter "N/A".

11.

Have you ever sold, released, or given away any confidential information?

Yes No
 

If you answered yes, please give the date (mm/dd/yyyy).

If you answered no, please enter "N/A".

12.

Are you a member or associate of a criminal enterprise, street gang, or any other group that advocates violence against individuals because of their race, religion, political affiliation, ethnic origin, nationality, gender, sexual preference or disability?

Yes No
 

If yes, please provide the name of the group that you are affiliated with.

If no, please enter "N/A".

13.

Have you ever filed a false insurance or workers’ compensation claim?

Yes No
 

If you answered yes, please give the date (mm/dd/yyyy).

If you answered no, please enter "N/A".

14.

Have you ever committed a crime(s) for which you have NOT been arrested for?

Yes No
 

If you answered yes, please provide the crime(s) and date(s) (mm/dd/yyyy).

If you answered no, please enter "N/A".


 

At any time in your life, have you EVER committed any of the following acts? (NOTE: You may NOT withhold any information regarding your involvement in any of the following acts, even if federal or state law relieved you from reporting the detention, arrest, or conviction that arose from it.)


15.

Murder, homicide, attempted murder or assault with the intent to commit murder

Yes No
16.

Arson

Yes No
17.

Assault with a deadly weapon

Yes No
18.

Child abuse or molestation

Yes No
19.

Forcible rape/Illegal sex acts

Yes No
20.

Hate crime

Yes No
21.

Perjury (lying under oath)

Yes No
22.

Elder abuse (physical and/or financial)

Yes No
23.

Possession of an explosive/destructive device

Yes No
24.

Robbery (theft from another person using a weapon, force, or fear)

Yes No
25.

Domestic violence

Yes No
26.

Kidnapping

Yes No
27.

Embezzlement

Yes No
28.

Manufacture/Cultivation of a controlled substance

Yes No

 

Have you ever used or experimented with any of the drugs listed below? This includes the unauthorized or illegal use of prescription medications. If you answered yes, please give the most recent date used (mm/dd/yyyy).

Your response should include but not be limited to your use of the following:


29.

Amphetamines/Methamphetamines (Uppers, Speed, Crank etc.)

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

30.

Barbiturates (Downers)

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

31.

Cocaine/Crack Cocaine

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

32.

Designer Drugs (Ecstasy, Synthetic Heroin, etc.)

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

33.

GHB (Date Rape Drug)

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

34.

Hallucinogens (Peyote, LSD, Mushrooms)

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

35.

Hashish/Hashish Oil

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

36.

Heroin/Opium

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

37.

Marijuana

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

38.

Mescaline

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

39.

Morphine

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

40.

PCP/Angel Dust

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

41.

Quaaludes

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

42.

Steroids

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

43.

Tetrahydrocannabinal (THC)

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

44.

Glue, paint, or any substance containing Toluene

Yes No
 

If you answered yes, please give the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".

45.

Have you used any illegal drugs that is not included in this list?

Yes No
 

If you answered yes, please provide the name of the drug(s) and the most recent date used (mm/dd/yyyy).

If you answered no, please enter "N/A".


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