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#CCT-8302-901904
Supplemental Questionnaire

Last Name
First Name

 

Instructions:  You must complete this Supplemental Questionnaire and submit it with your online application by the filing deadline, or your application will not be considered.  Please answer every question fully and completely.  Blank and/or incomplete answers will result in rejection of your application. Any falsification of this record may result in disqualification from this exam or dismissal from employment with the City & County of San Francisco.


1.

Are you at least 20 years old at the time of application for this recruitment?

Yes No
2.

Are you a U.S. citizen at the time of application for this recruitment?

Yes No
3.

Do you possess a U.S. high school diploma or have you passed an equivalency test (G.E.D. or California High School Proficiency Exam) or have attained a two-year or four-year degree or higher from an accredited U.S. college or university? 

Yes No
4.

Do you have one (1) year (equivalent to 2,080 hours) of any verifiable and satisfactory work experience, or have you completed one (1) year of any verifiable course work from an accredited U.S. college or university (30 semester hours/45 quarter units), or an equivalent combination?

Yes No
5.

Have you taken the California POST Entry-Level Law Enforcement Test Battery (PELLETB) and achieved a T-score of 46 or higher?  If YES, list your final T-score and the date (mm/dd/yy) that you took the test.  If NO, state "N/A."


 

A copy of your PELLETB scores, including final T-Score, must be submitted to dhr-publicsafety@sfgov.org by the deadline date and time.


6.

Do you currently possess a California POST-certified Basic Academy Certificate of Completion, a California POST Requalification Course Certificate or a California POST Basic Course Waiver Certificate?  If YES, state the type of the certificate you possess and the date of issue.  If NO, state "N/A."


 

A copy of your California P.O.S.T. certificate(s) must be submitted to dhr-publicsafety@sfgov.org by the deadline date and time.


7.

Are you currently enrolled in a California POST-certified Basic Academy?

Yes No
 

List the full name and complete address of the POST Basic Academy that you are currently attending.  Also state the month, day and year of your scheduled date of graduation from the POST Basic Academy.  If this question does not apply to you, state "N/A."

8.

Do you possess a valid Driver License at the time of application for this recruitment?

Yes No
9.

Have you ever been convicted of a felony?

Yes No
10
Have you been convicted of any misdemeanor, which included a penalty of prohibiting ownership, possession or control of a firearm? 
Yes No
11.

Have you ever been convicted of an offense involving domestic violence?

Yes No
12.

Are you restricted from employment with the City & County of San Francisco? 

Yes No
 
Self Certification 1:   I understand that on-call availability is required for this position.  I certify that I am able to work any shift (days, swings, midnights) on any day of the week, including weekends and holidays, as required.
Yes No
 

By checking this box, I attest that all of the statements that I have made in this employment application and Supplemental Questionnaire are true and accurate.