I
understand that my employment will be contingent upon the results
of a complete background investigation.
I am aware that any omission, falsification, misstatement or
misrepresentation will be the basis for my disqualification as an
applicant or my dismissal from the WKU Police Department.
I agree to the conditions and certify that all statements made
by me on this application are true, correct and complete, to the best
of my knowledge. I further fully understand and consent to a
polygraph examination concerning the truthfulness of my responses
to the information requested on this application or which is discovered
as a result of the background investigation, or any physical examination
or drug test. I also understand that I will be fingerprinted.
I understand that this employment application shall become
the property of the WKU Police Department.
I also understand that the information I give on the employment
application or the information discovered as a result of the background
investigation may be shared with another law enforcement agency should
I seek employment with that law enforcement agency.
I
also understand that I may be required to furnish the WKU Police Department
with a copy of my Income Tax Return for the year preceding this application
and for each year during my employment.
I
further understand and agree that my employment will be contingent
upon the results of a complete drug test and that I may be required
to take drug testing during the term of my employment with the Police
Department.
I
understand that my initial employment and continued employment my
be contingent upon the results of medical or psychological examinations
that I may be required to take during the term of my employment and
the maintenance of personal physical fitness, to the degree necessary,
to satisfactorily perform the duties of my position or assignment.
I
authorize any of the persons or organizations reference in this application
to furnish information personal or otherwise, regarding my ability
and fitness for employment and I relieve all such parties from any
and all liability for any damage that might result from furnishing
such information to the WKU Police Department.
I
agree to conform to the rules, regulations, and orders of the WKU Police
Department and acknowledge that these rules, regulations and order my
be changed, interpreted, withdrawn or added to by Western Kentucky University
or the university's police department at it's discretion, at any time
and without any prior noticed to me.
Signature_______________________________________ Date ____________________
Witnessed by: __________________________________________________