subject_line
Pronoun
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He
She
They/Them
First Name
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Middle Name:
Last Name
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SSN (ex: 123456789)
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Date of Birth (MM/DD/YYYY)
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State your SS# issued?
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Phone Number:
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Email Address
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Race
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Black
White
Hispanic
Asian
Bi-Racial
Other
Sex
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Male
Female
Other
Age
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Address 2
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City
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State
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Zip Code
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Are you a U.S. Citizen?
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I was born in the U.S.
I am a Naturalized Citizen.
I am not a Citizen
If you are a Naturalized Citizen, please tell me where you were born?
How Did You Hear About Us?
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Government Jobs
Indeed
News
Billboard
Radio
Social Media
Referral
Recruitment Truck
Other
Please explain how you heard about us.
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What Position are you applying for?
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Police Recruit (You presently live in GA)
Lateral Officer (You are a certified Police Officer in GA)
Out of State Recruit (You do not live in GA)
Out of State Lateral (You are a certified Police Officer, but not in GA)
Re-Hire (A Previous Atlanta Police Officer)
Are you applying for a Lateral Police Position?
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Yes
No
If Lateral, name your present department.
Do you have 2 years of patrol experience?
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Yes
No
Have you ever served in the Military?
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Never Served
Navy
Army
Marines
Coast Guard
Reserves
Air Force
Type of Discharge?
Honorable
Other than Honorable
Dishonorable
Medical
Under Honorable
Entry Level
Other
Driver License Status?
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Valid
Expired
Suspended
Revoked
Were you
arrested
for a DUI, Hit and Run, or Reckless Driving?
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DUI
Hit and Run
Reckless Driving
None
what year?
On Active Probation or Parole?
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Yes
No
Arrested for a Domestic Violence?
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Yes
No
Have you ever taken a plea to avoid a conviction?
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I am not a convicted felon.
I took a First Offender Plea
I took an Anger Management Plea
I pleaded guilty to a lesser charge
I have never been charged with a crime.
Convicted of a Felony?
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Yes
No
Convicted of a Misdemeanor?
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Yes
No
Ever
been arrested or given a desk appearance citation?
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Yes
No
What were you charged with?
0/15 characters
Convicted of Obstruction, Eluding, Assaulting a Law Enforcement Officer?
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Yes
No
Have you used an illegal drug?
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Yes
No
what year?
If "Yes", please provide the name of the drug or drugs used.
By signing below you agree that the information you have provided is true to the best of your knowledge. You understand that if you have provided false or misleading information this may disqualify you from our process. If you have any documentation supporting your answers, please take the time to upload that documentation.
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