Internship Application – City Of Florence

Florence Police Department

Service. Honor. Excellence.
Internship Program Application

Note: You must provide a copy of your driver’s license, high school academic transcript, and college transcript (if available) when submitting this application. Applications missing the previously mentioned documents will not be considered in the application process.

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Date of Application:

Full Name: *

Date of Birth:

Address: *

Address Line 1

City

State

Zip Code

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Home Phone Number: *

Alternate Phone Number: *

Social Security Number: *

Driver’s License Number: *

Do you have any medical disabilities? *

School/College Currently Attending:

Education

Classification:

Freshman
Sophomore
Junior
Senior

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School/College Organization Membership:

Sponsor & Phone Number:

Employment

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Employed?

Employer:

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Supervisor:

Phone Number:

Hours Worked per Week:

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Parents/Legal Guardian:

Address: *

Address Line 1

City

State

Zip Code

Parents/Legal Guardian Employer:

Signature of Parents/Legal Guardian:

References

Please provide three references of people that you have known for at least three years:

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First Person:

First Person Address:

First Person Phone:

Second Person:

Second Person Address:

Second Person Phone:

Third Person:

Third Person Address:

Third Person Phone:

Please write a summary of why you are interested in the Florence Police Department Ranger Program:

By signing below, I agree that all information on this application is true and correct to the best of my knowledge, and all required documents are attached with this application when I submit it. I understand that if any information contained on this application is falsified, or if any required documents are missing from the application, then this application will not be considered in the application process. My signature also represents my consent for a background check to be performed: *

Signature

Date

Welcome to Florence, Alabama

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Welcome to Florence, Alabama

Florence Police Department

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Employment

Guardian

References

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