ROYAL NEWFOUNDLAND CONSTABULARY POLICE CONSTABLE RECRUIT TRAINING PROGRAM

The Royal Newfoundland Constabulary (RNC) is currently accepting applications from individuals interested in a career as a Police Officer. The RNC is headquartered in St. John’s with detachments in Corner Brook, Labrador City/Wabush and Churchill Falls. Successful applicants may be assigned to any of these locations or to any other location that in the future, may be within the jurisdiction of the RNC. The Royal Newfoundland Constabulary is committed to gender and cultural diversity in the workplace and will be actively seeking applications from identifiable groups. Applicants must be a graduate of a degree program, OR have completed 15 university credit hours OR their equivalents from other recognized post-secondary institutions. The 15 credit hours must be completed by the end of the Winter Semester, April 2016 and should include six credit hours in English such as 1080, 1101, 1102, 1103 and/or 1110, six credit hours in Psychology such as 1000 and 1001, and three credit hours in Sociology, either 1000 or 2000. Other related educational qualifications may be considered. Applicants must be of high moral and ethical character and be capable of projecting a positive police role model to the community. Applicants must meet employment standards as stated in the RNC Act and participate in a selection process which involves screening, physical fitness testing, interview, polygraph, psychological assessment, medical assessment, reference checking, background investigation and Memorial University’s screening process. Police Officer positions with the RNC are considered “Positions of Trust” and require integrity and a high ethical standard. Dishonesty in any stage may result in your immediate dismissal from the application process. Successful candidates will be required to enroll in and complete the Police Studies Diploma Program offered by Memorial University beginning in September 2016. The program consists of two academic semesters followed by practical training at the RNC. Applicants must also meet the standards set by Memorial University for entry into the Police Studies Diploma Program. Further details on the diploma program and on admission crite ria to Me morial University a re available a t the following: http://www.mun.ca/regoff/calendar/sectionNo=ARTS-0307. Upon successful completion of the Police Studies Diploma Program, candidates will be eligible for employment at the RNC. CLOSING DATE FOR RECEIPT OF APPLICATIONS: Friday, November 13, 2015. Information for Applicants: Application packages are available on-line at www.rnc.gov.nl.ca, at the Human Resource Secretariat, Strategic Staffing Division 50 Mundy Pond Road (Public Service Commission Building) or at any RNC detachment. For further information contact the RNC Recruiting Unit at (709)729-8729 or [email protected]. Applicants must fully complete the RNC application package and clearly demonstrate that they meet all of the qualifications. Failure to do so may result in an applicant being screened out of the competition. Completed applications should be forwarded in person or by mail to: RNC Recruiting Unit Human Resource Secretariat, Strategic Staffing Division 50 Mundy Pond Road, PO Box 8700 St. John’s, NL A1B 4J6

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Police Constable Recruit Application Class of 2016-2017 Privacy Notice The personal information collected will be used to assess and screen Applications to the Police Constable Recruit Training Program with the Royal Newfoundland Constabulary. Use of the information will adhere to Newfoundland and Labrador's Access to Information and Protection of Privacy Act. For recruitment information, call (709) 729-8729 or check the website at www.rnc.gov.nl.ca/recruiting.

This Application is to be used only during a call for applications for the Police Constable Recruit Training Program.  This application must be handwritten by the applicant in clear and legible writing. Please use blue ink.  All questions must be answered. Where the question is not applicable, mark N/A. If you require additional space, attach a separate sheet.  All information supplied is subject to verification by investigation. Dishonesty at any stage may result in your immediate dismissal.  Complete addresses, including postal codes must be provided for each address given.  An essential component in the selection process for the RNC is a background investigation. Information gathered will be used to assess the suitability of the applicant for a career in policing. There will be a security check on applicants and members of their families and associates.  Information received will be held in the strictest confidence by the RNC Recruiting team.

All of the following must be submitted with your completed and signed application. Failure to do so may result in your application being screened out. Please read carefully.

       

Photocopy of Birth Certificate and/or Canadian Citizenship or permanent resident of Canada documentation Photocopy of Social Insurance Number (SIN) card or documented proof of SIN from Revenue Canada Photocopy of Valid Driver’s Licence Signed Authorization for the Release of Information Form and Acknowledgement and Declaration Form RNC Vision Standards Form (must be signed and dated after the date applications become available in September 2015 and before applications close in November 2015) Current resume with education and employment background clearly demonstrated Transcripts from all Colleges and Universities. If you are currently completing the required courses, please attach your current class schedule as verification of enrollment Two Passport Sized Photos (approx. 2x2 inches)

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PERSONAL INFORMATION LAST NAME

FIRST NAME

FULL MAILING ADDRESS

MIDDLE NAME(S)

CITY

TELEPHONE NUMBER TELEPHONE (HOME) NUMBER (CELL)

PROVINCE TELEPHONE (BUSINESS)

POSTAL CODE

DATE OF BIRTH Y/M/D

EMAIL ADDRESS If at any time you have used a surname or given name other than the one listed above, list change.

NAME CHANGED FROM

MUN STUDENT NUMBER, IF APPLICABLE DRIVER’S LICENCE #

PROVINCE

NAME CHANGED TO

DATE OF CHANGE Y/M/D

REASON FOR NAME CHANGE

CLASS(ES)

DATE OF ISSUE Y/M/D

RECRUITMENT INFORMATION How did you learn of the RNC’s recruitment initiative?

           

RNC Website RNC Facebook page RNC Twitter MUN Website Human Resource Secretariat, Online Job Portal Newspaper Advertisement Newscast Radio Advertisement Information Session RNC Member _________________ RNC Cadet ___________________ Other (Please Indicate Source)___________________

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Have you ever applied for employment with the Royal Newfoundland Constabulary or any other policing agency? (i.e. RCMP, OPP, Halifax Regional, etc.)

 

No Yes

Which agency? ________________________________________________ When did you apply? (List all attempts) _________________________________ Was your application for employment successful? If not, for what reason? __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ EDUCATIONAL PRE-REQUISITES Admission to the Police Studies Diploma Program is limited and competitive. Applicants for the Diploma Program must go through the multiple step recruitment process and be accepted as recruit cadets of the Royal Newfoundland Constabulary. They must also satisfy the general admission requirements of Memorial University and normally have the following educational background. Applicants must be a graduate of a degree program, OR have completed 15 university credit hours OR their equivalents from other recognized postsecondary institutions. The 15 credit hours must be completed by the end of the Winter Semester, April 2016 and should include six credit hours in English such as 1080, 1101, 1102, 1103 and/or 1110, six credit hours in Psychology such as 1000 and 1001, and three credit hours in Sociology, either 1000 or 2000. Other related educational qualifications may be considered. Final acceptance as a recruit cadet, following pre-selection, is therefore contingent on the assessment of a formal application for admission to Memorial University and confirmation by the university of eligibility for the Diploma Program in Police Studies. Further details on the Diploma Program and on admission criteria to Memorial University are available at www.mun.ca/arts/diploma/police. Have you completed the following courses/program? Degree Program

 Yes

 No

 To Be Completed by_______________

Other Post Secondary Program

 Yes

 No

 To Be Completed by_______________

Six credit hours in English

 Yes

 No

 To Be Completed by_______________

Six credit hours in Psychology

 Yes

 No

 To Be Completed by_______________

Three credit hours in Sociology

 Yes

 No

 To Be Completed by_______________

Transcripts from all Colleges and Universities are to be included with your application. If you are currently in the process of completing the required courses, please attach your current class schedule as verification of enrollment.

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EDUCATION HISTORY HIGH SCHOOL

NAME OF SCHOOL

CITY

DIPLOMA OBTAINED

GED OBTAINED

UNIVERSITY

NAME OF SCHOOL

CITY

PROGRAM COURSE, MAJOR/MINOR

START DATE YYYY MM

LENGTH OF COURSE

CERTIFICATE, DIPLOMA OR DEGREE AWARDED? (If no, provide details)

UNIVERSITY

GRADE POINT AVERAGE

NAME OF SCHOOL

FINISH DATE YYYY MM

CITY

PROGRAM COURSE, MAJOR/MINOR

START DATE YYYY MM

LENGTH OF COURSE

CERTIFICATE, DIPLOMA OR DEGREE AWARDED? (If no, provide details)

GRADE POINT AVERAGE

COLLEGE, BUSINESS NAME OF SCHOOL SCHOOL,TECHNICAL SCHOOL PROGRAM COURSE, MAJOR/MINOR

LENGTH OF COURSE

GRADE POINT AVERAGE

COLLEGE, BUSINESS NAME OF SCHOOL SCHOOL,TECHNICAL SCHOOL PROGRAM COURSE, MAJOR/MINOR

LENGTH OF COURSE

GRADE POINT AVERAGE

FINISH DATE YYYY MM

CITY

START DATE YYYY MM

FINISH DATE YYYY MM

CERTIFICATE, DIPLOMA OR LICENCE AWARDED? (If no, provide details) CITY

START DATE YYYY MM

FINISH DATE YYYY MM

CERTIFICATE, DIPLOMA OR LICENCE AWARDED? (If no, provide details)

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EMPLOYMENT HISTORY Begin with your most recent employer and continue in reverse time order. Provide history for the last 10 years, if applicable. Also include any volunteer or community work and indicate (v) in the “position held” to designate them as volunteer. Attach additional sheets, if necessary, following the same format.

Most Recent

Organization

Telephone Number ( )

Organization’s Address

Postal Code

Contact Person & Email Address

Start Date

YY

MM

Finish Date

YY

MM

Position Held

Reason For Leaving:

Organization

Telephone Number ( )

Organization’s Address

Postal Code

Contact Person & Email Address

Start Date

YY

MM

Finish Date

YY

MM

Position Held

Reason For Leaving:

Organization

Telephone Number ( )

Organization’s Address

Postal Code

Contact Person & Email Address

Start Date

YY

MM

Finish Date

YY

MM

Position Held

Reason For Leaving:

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EMPLOYMENT HISTORY Organization

Telephone Number ( )

Organization’s Address

Postal Code

Contact Person & Email Address

Start Date

YY

MM

Finish Date

YY

MM

Position Held

Reason For Leaving:

Organization

Telephone Number ( )

Organization’s Address

Postal Code

Contact Person & Email Address

Start Date

YY

MM

Finish Date

YY

MM

Position Held

Reason For Leaving:

Organization

Telephone Number ( )

Organization’s Address

Postal Code

Contact Person & Email Address

Start Date

YY

MM

Finish Date

YY

MM

Position Held

Reason For Leaving:

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EMPLOYMENT HISTORY Organization

Telephone Number ( )

Organization’s Address

Postal Code

Contact Person & Email Address

Start Date

YY

MM

Finish Date

YY

MM

Position Held

Reason For Leaving:

Organization

Telephone Number ( )

Organization’s Address

Postal Code

Contact Person & Email Address

Start Date

YY

MM

Finish Date

YY

MM

Position Held

Reason For Leaving:

Please provide an explanation, with dates, for all gaps in employment.

__________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

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REFERENCES Applicants are to list six adults, who are not related to you, who we may contact and who are competent to judge your character, temperament, and work habits. References must have definite knowledge of your qualifications and suitability to become a Police Officer. Please include 3 character and 3 employment references.

CHARACTER REFERENCES (1) SURNAME (AND MAIDEN)

GIVEN NAMES

FULL ADDRESS RESIDENCE TELEPHONE ( ) OCCUPATION

POSTAL CODE CELL PHONE ( )

EMAIL ADDRESS

YEARS KNOWN

RELATIONSHIP TO APPLICANT

(2) SURNAME (AND MAIDEN)

GIVEN NAMES

FULL ADDRESS RESIDENCE TELEPHONE ( ) OCCUPATION

POSTAL CODE CELL PHONE ( )

EMAIL ADDRESS

YEARS KNOWN

RELATIONSHIP TO APPLICANT

(3) SURNAME (AND MAIDEN)

GIVEN NAMES

FULL ADDRESS RESIDENCE TELEPHONE ( ) OCCUPATION

POSTAL CODE CELL PHONE ( )

EMAIL ADDRESS

YEARS KNOWN

RELATIONSHIP TO APPLICANT

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EMPLOYMENT REFERENCES (1) SURNAME (AND MAIDEN)

GIVEN NAMES

FULL ADDRESS CELL PHONE ( )

POSTAL CODE BUSINESS TELEPHONE ( )

OCCUPATION

EMAIL ADDRESS YEARS KNOWN

RELATIONSHIP TO APPLICANT

(2) SURNAME (AND MAIDEN)

GIVEN NAMES

FULL ADDRESS CELL PHONE ( )

POSTAL CODE BUSINESS TELEPHONE ( )

OCCUPATION

EMAIL ADDRESS YEARS KNOWN

RELATIONSHIP TO APPLICANT

(3) SURNAME (AND MAIDEN)

GIVEN NAMES

FULL ADDRESS CELL PHONE ( ) OCCUPATION

POSTAL CODE BUSINESS TELEPHONE ( )

EMAIL ADDRESS YEARS KNOWN

RELATIONSHIP TO APPLICANT

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ADDITIONAL SKILLS Please include:  Courses completed (include expiry dates)  Workshops/seminars  Computer skills  Additional written/spoken languages, etc. Applicants may list skills in jot-note form.

__________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ HOBBIES AND PERSONAL INTERESTS __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

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SECURITY CLEARANCE DECLARATION The following pages request detailed information regarding you, your family and your associates. This information is required to determine your eligibility for training with the Royal Newfoundland Constabulary. The information provided will be held in the strictest confidence. Ensure that all sections are completed. Failure to do so may result in your application being dismissed. Attach additional sheets, if required, in the same format.

SURNAME

FIRST NAME

MIDDLE NAME(S)

MAIDEN/OTHER NAMES USED

PREFERRED FIRST NAME

CURRENT ADDRESS

POSTAL CODE

TELEPHONE NUMBER ( ) PLACE OF BIRTH (INCLUDE CITY/COUNTRY)

DATE OF BIRTH Y/M/D

SIGNIFICANT OTHER (i.e. boyfriend/girlfriend) If you have checked married, common-law, domestic partner, or significant other please give full name and date of birth of your partner.

SURNAME/MAIDEN/OTHER

FIRST NAME

MIDDLE NAME(S)

DATE OF BIRTH Y/M/D

In chronological order, most recent first, indicate every place you have resided in the last 10 years. Please estimate age if exact date of birth cannot be obtained for person(s) whom you have shared an address with. ADDRESS/CITY/PROVINCE/POSTAL CODE

FROM (Y/M/D)

TO (Y/M/D)

NAMES OF PERSON(S) WHO SHARE ADDRESS

RELATIONSHIP

DATE OF BIRTH Y/M/D

ADDRESS/CITY/PROVINCE/POSTAL CODE

FROM (Y/M/D)

TO (Y/M/D)

NAMES OF PERSON(S) WHO SHARE ADDRESS

RELATIONSHIP

DATE OF BIRTH Y/M/D

PHONE NUMBER

PHONE NUMBER

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ADDRESS/CITY/PROVINCE/POSTAL CODE

FROM (Y/M/D)

TO (Y/M/D)

NAMES OF PERSON(S) WHO SHARE ADDRESS

RELATIONSHIP

DATE OF BIRTH Y/M/D

ADDRESS/CITY/PROVINCE/POSTAL CODE

FROM (Y/M/D)

TO (Y/M/D)

NAMES OF PERSON(S) WHO SHARE ADDRESS

RELATIONSHIP

DATE OF BIRTH Y/M/D

ADDRESS/CITY/PROVINCE/POSTAL CODE

FROM (Y/M/D)

TO (Y/M/D)

NAMES OF PERSON(S) WHO SHARE ADDRESS

RELATIONSHIP

DATE OF BIRTH Y/M/D

ADDRESS/CITY/PROVINCE/POSTAL CODE

FROM (Y/M/D)

TO (Y/M/D)

NAMES OF PERSON(S) WHO SHARE ADDRESS

RELATIONSHIP

DATE OF BIRTH Y/M/D

PHONE NUMBER

PHONE NUMBER

PHONE NUMBER

PHONE NUMBER

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FAMILY MEMBERS Applicants must include immediate relatives and the immediate relatives of their current/former spouse, domestic partner, common-law or significant other. Immediate relatives include parent, step-parents, guardians, children, step-children, adopted children, brother/sister, step-brother/sister, adopted brother/sister, brother/sister in-law, living or deceased. Please ensure FULL NAMES are included. Attach additional sheets, if required, in the same format. SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

FIRST NAME

ADDRESS

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

COMMON NAME USED CITY

COMMON NAME USED CITY

COMMON NAME USED CITY

COMMON NAME USED CITY

COMMON NAME USED CITY

COMMON NAME USED CITY

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

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SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

ADDRESS

SURNAME / (MAIDEN NAME) / OTHER NAMES USED RELATIONSHIP

FIRST NAME

FIRST NAME

ADDRESS

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

MIDDLE NAME

Phone Number ( )

COMMON NAME USED CITY

COMMON NAME USED CITY

COMMON NAME USED CITY

COMMON NAME USED CITY

COMMON NAME USED CITY

COMMON NAME USED CITY

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

DATE OF BIRTH YYYY MM DD PROVINCE

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DRIVING

1.

a) Do you possess a valid Driver’s Licence at this time? (This does not include a Graduated Licence)

 

No

Yes If yes, from where? If no, please answer 1b. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

 

b) Do you possess a Graduated Driver’s Licence? No

Yes If yes, from where and what date was it issued? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

2.

Have you ever possessed a valid driver’s licence from any where other than Newfoundland and Labrador?

 

No

Yes If yes, from where? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

3.

Has your current or any past driver’s licence ever been suspended?

 

No

Yes If yes, provide place, date, time and reason of each suspension. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

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4.

(a) Have you, as the driver, been involved in any motor vehicle accidents during the past five years?

 

No

Yes If yes, provide details of the accident(s) including: Places, dates and times of each accident, were you at fault, were you charged, is there any outstanding litigation concerning these? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ (b) Referring to question 4(a), in how many of those accidents were you impaired by drugs or alcohol? If any, please provide dates, location and circumstances. Location (City, Province/State, Country)

Date

5.

Circumstances

Have you ever been a driver or passenger in a motor vehicle when it was involved in a hit and run accident, even when damage was minor?

 

No

Yes If yes, provide details including places, dates and times of each incident. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

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In question 6, “impaired” includes but is not limited to occasions where, because of alcohol and/or drug consumption, you knew or physically felt that you were not able to drive the vehicle in the same manner as you would have been able to without consuming alcohol/drugs.

6.

Have you ever driven or operated any motorized vehicles or vessels after consuming alcohol or any other form of impairment?

 

No Yes

If yes, were you impaired?

 

No Yes

In order to accurately assess level of impairment, please provide details including: The amount of alcohol consumed, the time period it was consumed, and the place, dates and times of each incident ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

7.

Have you ever been chased or pursued by the police? ( i.e. a foot or motor vehicle chase)

 

No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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8.

How much alcohol do you consume per week, on average? Type of Alcohol

9.

Amount and Frequency

Circumstances of Use

a) Have you ever been intoxicated?

 

No Yes

b) If yes, how many times have you been intoxicated in the past 12 months? __________ Please provide information for each instance…. Type of Alcohol

10.

 

Amount and Frequency

Circumstances of Use

Have you ever purchased alcohol while underage, purchased alcohol for or, given alcohol to anyone who was underage? Have you ever used a fake ID to purchase alcohol while underage? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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11.

Have you ever been in a verbal or physical altercation while under the influence of alcohol?

 

No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

12.

 

Has alcohol consumption ever caused a problem in any aspect of your life? (i.e. employment, family, school or otherwise) No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

13.

 

Have you ever been disciplined, asked to resign or dismissed from a position because of alcohol related concerns? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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14.

 

Has anyone ever seriously told you that you drink too much? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

15.

 

(a) Have you ever been, or are you now, dependant on alcohol? No Yes

(b) If yes, have you ever received any type of substance abuse counseling or been involved in an alcohol treatment program? Please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

16.

 

Have you ever consumed alcohol on the job, outside of organized social events? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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17.

What is the worst thing you have ever done as a result of drinking alcohol?

______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ DRUG USE

18.

 

Have you ever used or experimented with any illegal drugs? No

Yes If yes, please provide requested information for each drug and explain circumstances of use below. Drug Type

Used Yes No

Date of First Use

Date of Last Use

Total # of Times Used

Marijuana Hash Hash Oil Weed Oil Cocaine Crack/Rock/Powder Heroin Anabolic/growth hormone steroids Methamphetamine Mushrooms Acid/LSD PCP Crystal Meth Inhalants (glue, gasoline, paint) Mescaline Ketamine Designer (homemade) Date Rape (DMX, GHB, Rohyphonol) Ecstasy Bath Salts Other (specify) ___________________ Other (specify) ___________________

______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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19.

 

Have you ever illegally used any pharmaceutical (prescription) drugs? No

Yes If yes, please provide information for each drug and explain circumstances of use below. Used Drug Type

Yes

No

Date of First Use

Date of Last Use

Total # of Times Used

Methadone Percocet Percoden Valium Prozac Zanax Ritalin Oxycontine Oxycodine Dilaudid Inhalants Other (specify) ________________ Other (specify) ________________ Other (specify)_________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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20.

 

Have you ever illegally purchased street or prescription drugs? No

Yes If yes, please provide details and dates regarding the purchase and your involvement. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

21.

 

Have you ever sold, given away or offered illegal street or prescription drugs? No

Yes If yes, please provide details including dates, type of drug(s) and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

22.

 

Have you ever grown or produced illegal drugs? No

Yes If yes, please provide specific details including dates, type of drug(s) and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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23.

 

Have you ever imported or exported any illegal street or prescription drugs? No

Yes If yes, please provide specific details including dates, type of drug(s) and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

24.

 

a) Do you associate with anyone who uses or has used illegal drugs (i.e. friends, girlfriends, boyfriends, relatives, husbands, wives, coworkers etc.)? How often do you associate with the persons identified? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

 

b) Do you frequent places where illegal drugs are being used? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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25.

 

Have you ever transported, held or stored any illegal drugs? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

CREDIT

26.

 

Have you ever declared bankruptcy? No

Yes If yes, please provide details including location, date(s) filed and discharge dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

27.

 

Has a collection agency ever been assigned to any of your outstanding debts? No

Yes If yes, please provide details including location, dates and amounts. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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28.

 

Have you ever knowingly written an NSF (Non-Sufficient Funds) cheque, deposited an empty envelope into a bank machine, or taken part in any other fraudulent banking transaction(s)? No

Yes If yes, please provide details including dates and amounts. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

29.

 

Are you currently having financial difficulties? No

Yes If yes, please provide details including dates and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

30.

 

a) Do you gamble (including lottery tickets, scratch tickets, VLT, etc)? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

b) How much money have you spent in the last 12 months as a result of gambling? Please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

27

31.

 

Do you presently owe any gambling debts to anyone? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

32.

 

Have you ever had contact with a professional bookmaker (bookie)? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ SCHOOL & EMPLOYMENT HABITS

33.

 

Have you ever cheated on any form of examination or plagiarized another person’s work? (This includes education and/or employment as well as your application to the RNC.) No

Yes If yes, please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

28

34.

 

Have you ever been suspended or formally reprimanded by an educational institution or employer? No

Yes If yes, please provide details of the event(s): ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

35.

 

Other than for valid medical reasons, have you ever had problems with absenteeism or late attendance while you were a student or an employee? No

Yes If yes, please provide details including date, frequency and reason. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

36.

 

Have you ever held any employment, or earned cash income, where you did not report this income as required by law or intentionally did not pay income taxes? No Yes

If yes, please provide details including dates, amount earned, employer(s) and reason why. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

29

37.

 

Have you ever been dismissed or asked to resign from a job? No

Yes If yes, please provide details including your position, the employer and the reason for your dismissal or resignation. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

38.

 

Have you ever been accused of dishonesty or have you ever lied to a supervisor in relation to any employment? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

PROSTITUTION

39.

 

Have you ever communicated for the purpose of prostitution, or obtained any sexual services from a prostitute or an escort, in Canada or elsewhere, i.e., at a strip club, street prostitution, brothel, massage parlour, via the internet, etc…? No

Yes If yes, please provide details including: when, where, and how many times it occurred. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

30

40.

 

Have you ever engaged in a sex act for monetary purposes? No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

41.

 

Have you ever accepted the earnings of a prostitute? No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

ILLEGAL SEXUAL ACTIVITY

42.

 

Have you ever committed an illegal sexual act? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

31

43.

 

Have you ever used physical force or any type of threat in order to have sexual relations with someone? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

44.

 

Have you ever had sexual contact/involvement with any person without their knowledge or consent, which includes persons who were unable to give consent due to a medical condition, mental health issue, alcohol or drug impairment, or other reason? No

Yes If yes, please provide details including dates, location and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ NOTE: Questions 45 and 46 do not include situations where ALL of the following apply: – the other person was over the age of 12 and you were less than two years older than the other person, OR the other person was over the age of 14 and you were less than 5 years older than the other person, – you were not in a position of trust or authority towards that person, AND – both parties consented to the activity.

45.

 

Have you ever been involved in a sexual manner with a person under the age of 16, whether in person or via internet, email, chat-lines, etc.? No

Yes If yes, please provide details including your age at the time, relationship to the person who was under 16, and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

32

46.

 

Have you ever asked or persuaded a person under the age of 16 to participate in any sexual activity? No Yes

If yes, please provide details including dates, location, your age at the time, relationship to the person who was under 16, and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

47.

 

Have you ever participated directly or indirectly in sexual activity with any person under the age of 18 years while being in a position of trust or authority over that person? A position of trust and authority over a person includes babysitter, coach, boss, etc. No Yes

If yes, please provide details including dates, location and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

48.

 

Have you ever committed incest? (excludes victimization) No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

33

49.

 

Have you ever engaged in bestiality? (any sexual activity with an animal) No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

50.

 

Have you ever given anyone a drug or any substance, without their knowledge? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

51.

 

Have you ever made anonymous or unwanted phone calls? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

52.

 

Have you deliberately exposed yourself to anyone in public? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

34

53.

 

Have any nude photos/videos been taken of you? Either by you or any other person? No

Yes Is it possible that nude photos/videos of you still exist? Please explain where and when they came into existence and who may have or had possession. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

54.

 

Have you ever sent nude photos/videos of yourself? No

Yes If yes, please explain when and to whom you sent them. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

55.

 

Have you ever recorded and/or shared, by any media, sexual acts of another person with or without their knowledge? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

35

56.

 

Have you ever intentionally or unintentionally accessed, viewed, downloaded, purchased, received, manufactured, made, distributed, sold, possessed or produced child pornography in any form? (i.e. materials that are written, visual, audio, photographic, film, video, and/or electronic materials showing a person who is or appears to be under 18 years of age) No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

57.

 

Have you ever attempted to mislead or lure a person under the age of 18 with the intent of pursuing any sexual activity? Include internet chat room activity. No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ USE OF FORCE

58.

 

Have you ever been in a physical altercation with a spouse, partner, child or any other person associated to you in a domestic or family relationship? No Yes

If yes, please provide details including dates and relationship. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

36

59.

 

Have you ever been in a physical altercation with an adult person? (sports or otherwise) No Yes

If yes, please provide details including with whom, dates, location, circumstances and any injuries. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

60.

 

Have you ever resisted, assaulted, been in a fight with, or acted aggressively toward a Police Officer? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

61.

What is the worst thing anyone is going to say you have done to them? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

62.

 

Have you ever been verbally abusive or threatening to anyone? (intimidation, bullying, road rage, etc.) No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

37

63.

 

Have you ever used a weapon or firearm to intimidate or threaten another person? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

64.

 

Have you ever injured yourself or someone else with a firearm or weapon? No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

65.

 

Could you use physical force to affect an arrest if it was necessary and approved by departmental policy? No Yes

Please explain. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

38

66.

Could you shoot another person if it became necessary and was approved by departmental policy?

 

No Yes

Please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

67.

Are there any policing duties that you may find difficult to perform due to, physical, personal, moral or religious reasons?

 

No Yes

Please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ THEFT

68.

Have you ever been involved, directly or indirectly, in a theft? (shoplifting, theft of/from vehicle, or theft from family member/friend)

 

No

Yes If yes, please provide details – including: What was stolen, from whom was it stolen, the date(s) of the offence(s), why you committed the theft(s), and what happened to the property? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

39

69.

 

Have you ever been involved in any criminal activity at any of your workplaces? (theft of merchandise, office supplies, money, misappropriation of funds, fraud, or converting anything to your personal use without authorization) No

Yes If yes, please provide details including dates, position within company, employer and type of property. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

70.

 

Have you ever purchased or been given anything you thought or knew was obtained from a crime? No

Yes If yes, please provide details including dates, type of property, how you obtained it and if you are still in possession of this property. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

71.

 

Are you currently in possession of any stolen property? No

Yes If yes, provide details including what property and where/how it was obtained. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

40

72.

 

Have you ever been a passenger or driver of a stolen vehicle? No

Yes If yes, please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

TECHNOLOGICAL CRIME

73.

 

Have you ever illegally downloaded, streamed, sold, given away or otherwise obtained any software or media content (this includes movies, tv shows, music files)? No Yes

If yes, please provide details – including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

74.

 

Have you ever hacked, or attempted to hack, or gained unauthorized access into any computer system without permission? No Yes

If yes, please provide details – including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

41

75.

 

Have you ever threatened, harassed or stalked anyone over the internet? No Yes

If yes, please provide details – including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

76.

 

Have you ever written, compiled, created, or knowingly distributed, a computer virus, worm, Trojan or an illegal SPAM via the internet or e-mail? No Yes

If yes, please provide details – including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

77.

 

Have you ever purposely damaged, destroyed, or corrupted data/hardware on any computer system? No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

42

78.

 

Have you ever used the internet for the purpose of committing fraud or any other Criminal Code offence? (child pornography, hacking, harassment, theft of software, etc.) No

Yes If yes, please provide details including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ OTHER CRIMINAL ACTIVITY

79.

Aside from any previously disclosed information, please list any undetected criminal activity you have ever been involved in. Be as specific and detailed as possible.

______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ (b) What is the most serious undetected crime you have ever been involved in? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

80.

 

Have you ever committed perjury while giving testimony under oath as a witness, victim or accused, or ever affirmed or sworn to a false document? No

Yes Please provide details including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

43

81.

 

Have you ever been convicted, charged or involved in any way in a criminal offence in Canada or in any other country? No

Yes Please provide details including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

82.

Have you ever committed, participated or been involved in any of the following Criminal Code offences: Arson………………….  No  Yes Murder……………….. Robbery……………… Vandalism…………… Fraud………………… Kidnapping…….…….. Bombing…………....... Break and Enter…..… Harassment/stalking... Cruelty to animals…...

 No  No  No  No  No  No  No  No  No

        

Yes Yes Yes Yes Yes Yes Yes Yes Yes

If you marked yes to any offence, please provide details of the offence(s). ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

44

83.

 

Have you ever been involved in any type of fraud? (Insurance fraud, price tag switching, vehicle odometer rollback, Income Tax, Employment Insurance, etc.) No Yes

Please provide details including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

84.

 

Have you ever deliberately falsified any official documents? (Income Tax, Customs, Employment Insurance, student loans, credit applications, bank documents, insurance claims, etc.) No Yes

Please provide details including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

85.

 

Have you ever, or do you currently, associate with individuals or groups who are/were engaged in criminal activity? (Racial gangs, motorcycle gangs, street gangs, organized crime groups, white supremacist groups, protest action groups, terrorist networks or cells, etc.) No Yes

Please provide details including dates, individuals and criminal activity. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

45

86.

 

Have you ever researched, manufactured or used an explosive device or flammable devices? (Bombs, Molotov cocktails, pipe bombs, etc.) No Yes

Please provide details including dates and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

INVOLVEMENT WITH LAW ENFORCEMENT

87.

 

Other than traffic violations or for your work capacity, have you ever been checked by the police where information about you was documented in any manner? No Yes

Please provide details including dates and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

88.

 

Have you been involved in, in attendance or present during any circumstance where police were called or responded? No Yes

Please provide details including dates and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

46

89.

 

Have you ever been refused security clearance or bond? No Yes

Please provide details including dates and circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

90.

 

Have you ever impersonated a police officer? No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

91.

 

Have you ever lied to a police officer? No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

47

92.

 

Have you ever hidden anyone from the police or helped anyone avoid being arrested? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

93.

 

Have you ever done anything for which you could have been arrested? No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

94.

 

Were you ever present when a serious crime was being committed? (assault, etc.) No

Yes If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

48

FIREARMS

95.

 

(a) Do you own or possess any licensed and/or unlicensed firearms? No

Yes If yes, please describe firearm and continue to (b). ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ (b) If you own/possess a firearm, have you applied for/do you have a firearm’s licence?

 

No

Yes Please provide circumstances if applicable. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

96.

 

Have you ever been refused a firearm’s licence? No

Yes If yes, please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

49

97.

  

If you own a firearm, is it stored in accordance with current legislation? No Yes Not applicable

If no, describe how the firearm is stored. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

98.

 

Do you possess or own any prohibited weapons? (brass knuckles, crossbow, morning star, spike wristband, switch blade, Nunchaku sticks, etc.) No Yes

If yes, please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

FISH & GAME

99.

 

Have you ever committed any fish and game violations? No Yes

Please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

50

100. Have you ever illegally transported a firearm in a motor vehicle?

 

No Yes

Please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

TELECOMMUNICATIONS

101. Do you possess or own an illegal satellite receiver system or have illegal cable/internet access?

 

No Yes

If yes, please describe product and circumstances if applicable. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

BACKGROUND

102. Are you aware of any reasons that may disqualify you from becoming a Police Officer with the Royal Newfoundland Constabulary?

 

No Yes

Please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

51

103. Do you have any physical disability or condition that may affect your ability to perform policing duties?

 

No Yes

Please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

104. Are you currently, or have you been, a client of the Workplace, Health, Safety and Compensation Commission?

 

No Yes

Please provide details including dates. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

105. Have you ever suffered from or have you ever been treated for clinical depression or anxiety disorder?

 

No Yes

If yes, please provide details including time period. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

52

106. Have you ever been prescribed anti-depressant medication?

 

No Yes

If yes, please provide details of the drug, dosage, time frame. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

107. Have you ever tried or seriously considered taking your life?

 

No Yes

Please provide details including dates, circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

108. Have you ever been referred to or been seen by a mental health professional?

 

No Yes

Please provide details including dates, circumstances. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

53

109. Have you ever been tested, diagnosed, or prescribed medication for a learning disorder?

 

No Yes

If yes, please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

110. Do you have any phobias?

 

No Yes

If yes, please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

111.

 

Are you associated with any companies or businesses not listed in your application? Are you a member of any clubs or organizations? Do you hold a position there? No Yes

If yes, please provide specific details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

54

112. In the past ten years, have you been involved in any litigation suits?

 

No Yes

If yes, please provide specific details including type, status, outcome. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

113. Have you ever been involved in ANY criminal activity that you have not previously disclosed or documented?

 

No Yes

Please provide details including dates, circumstances and type of crime. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

114. Have you ever knowingly provided any false information or deliberately

withheld any information in your application to the Royal Newfoundland Constabulary?

 

No Yes

Please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

55

115. Is there any information you wish to add or disclose that you feel the Royal Newfoundland Constabulary should be aware of? Non-disclosure may affect the status of your application.

 

No Yes

Please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

All issues MUST be disclosed in advance of the polygraph examination or disqualification will be considered. Should you have any questions or concerns, you are advised to contact the RNC Recruiting Unit at (709)729-8729 or through email at [email protected].

56

NOTE: The following section is intended for candidates with previous law enforcement experience and addresses issues reflective of their ethics and integrity. “Law enforcement” includes police officer, peace officer, special constable, sheriff, corrections officer, bylaw officer or military police officer.

If you DO NOT HAVE previous police experience … Please proceed to Acknowledgement and Declaration Form on Page 66 and the Authorization for the Release of Information Form on Page 67.

FOR PREVIOUS LAW ENFORCEMENT EXPERIENCE ONLY

NOTE: The following section is intended for candidates with previous law enforcement experience and addresses issues reflective of their ethics and integrity.

“Law enforcement” includes police officer, peace officer, special constable, sheriff, corrections officer, bylaw officer or military police officer.

57

116. Where and when did you receive your law enforcement recruit training? Please provide details. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

117. How many years of law enforcement experience have you accumulated? Please provide circumstances if applicable. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

118. Presently, what rank do you hold? If promoted, please identify when this occurred?

______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

119. Have you been, or are you now, the subject of civil litigation as a result of your duties as a law enforcement officer?

 

No Yes

Please provide details if applicable. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

58

120. Have you been, or are you now, the subject of an internal or external investigation as a result of your duties as a law enforcement officer?

 

No Yes

Please provide details if applicable. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

121. Were you ever disciplined for inappropriate conduct or unauthorized conduct while employed as a law enforcement officer?

 

No Yes

Please provide details if applicable. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

122. Were you ever absent from duty for any extended periods of time other than for authorized purposes or medical reasons?

 

No Yes

Please provide details if applicable. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

59

123. Have you ever deliberately committed any criminal act while employed as a

law enforcement officer that, if detected, you could / would face prosecution?

 

No Yes

Please provide details if applicable. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

124. (a)As a law enforcement officer, were you ever with another officer when they committed a crime?

 No  Yes If yes, please explain and complete question (b). ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ (b)

Did you report the incident?  No

 Yes If no, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

60

125. Have you ever been involved in a situation where you deliberately neglected your duties or intentionally violated policy and procedure?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

126. As a law enforcement officer, have you ever received a kickback or accepted a bribe?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

127. As a law enforcement officer, have you ever falsified a police report? (i.e.

evidence receipts, criminal investigations, falsified written statements, police log, etc.)

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

61

128. As a law enforcement officer, have you ever intentionally made a false arrest?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

129. As a law enforcement officer, have you ever used excessive force?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

130. As a law enforcement officer, have you ever illegally destroyed any seized evidence?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

62

131. As a law enforcement officer, have you ever, with or without authorization, taken exhibits for your own personal use or gain?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

132. As a law enforcement officer, have you ever stolen anything from your department?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

133. As a law enforcement officer, have you ever stolen anything from a crime

scene, accident scene, property room, vehicle, victim or accused person?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

63

134. As a law enforcement officer, have you ever unlawfully used, sold or possessed any illegal drugs?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

135. As a law enforcement officer, have you ever used your position for personal gain?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

136. Have you ever engaged in a sexual act with a prisoner or anyone else in your custody (i.e. witness), or with anyone directly related to your investigation?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

64

137. Have you ever told a relative, friend or acquaintance about an active investigation that involved them or someone they knew?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

138. Have you ever intentionally covered up an offence for a relative, friend or acquaintance?

 

No Yes

If yes, please explain. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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ACKNOWLEDGMENT AND DECLARATION

In making application for the position of police constable with the Royal Newfoundland Constabulary I hereby acknowledge that, 1. The Royal Newfoundland Constabulary will seek to obtain any and all information pertaining to any criminal conviction and/or criminal findings of guilt in relation to me and will seek detailed information regarding my personal and credit history, my family and associates, and I consent to the collection of same. 2. I may have to attend at the Identification Section of the Royal Newfoundland Constabulary for fingerprint confirmation and agree to do so as required. 3. Honesty, integrity and ethics are matters important to and closely scrutinized by the Royal Newfoundland Constabulary when considering applicants for the position of police constable. I undertake to answer all questions pertaining to these matters accurately, completely and honestly and I understand that my answers to these questions will be verified by a variety of means including a detailed background investigation and a polygraph examination. 4. Deceit, dishonesty and non-disclosure concerning questions in this application will result in disqualification of me from this and any further competitions with the Royal Newfoundland Constabulary. 5. All information contained in this application is true and complete. 6. Pursuant to Section 55 of the Royal Newfoundland Constabulary Act, 1992, a person who by false certificates, false representations or by concealment of a fact is to be employed or is employed by the Constabulary shall upon discovery of those false certificates or representations or that concealment be refused training/employment by the Constabulary or dismissed from the training program/employment and that person may be denied pay, gratuity or pension. 7. I am involved in a competitive selection process and I may be declined at any stage of the process. 8. The terms of this Acknowledgment and Declaration Form are fully understood by me. 9. I further agree to absolutely release, discharge and absolve the Royal Newfoundland Constabulary and Her Majesty in Right of Newfoundland and Labrador and its employees from all claims, losses or damages including indirect consequential, occasioned by me during, or as a result of, any investigation in relation to my personal history including any criminal conviction and/or criminal finding of guilt associated to my name. Applicant’s Signature:

Date:

Witness Signature:

Date:

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AUTHORIZATION FOR RELEASE OF INFORMATION

I,____________________, the undersigned, hereby authorize any person, employer, organization or physician to provide any information, opinion, reports, records, documents or copies thereof in any form which may be requested in connection with my application for employment with the Royal Newfoundland Constabulary and any subsequent training. Personal information about me will be used to assess my qualifications and suitability in relation to my application as a Police Officer. I consent to the collection, use, disclosure, transmittal and examination of all information compiled by the Royal Newfoundland Constabulary. Personal information about me that is obtained during the selection process, or any subsequent training and employment, may be disclosed to any law enforcement agency for the purpose for which it was obtained or for any other reason. I agree to waive any right of action against any person or organization providing information or opinions in compliance with this authorization. I hereby acknowledge and declare the terms of this authorization for release of information are fully understood by me.

Applicant’s Signature:

Date:

Witness Signature:

Date:

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RNC Police Cadet Competencies Deportment: Creating a good first impression, commanding attention and respect, showing an air of confidence. Applicants will have the opportunity to discuss the skills they possess that would make them a competent police officer and an asset to the RNC. Effective Communication: Expressing ideas effectively in individual and group situations (including non verbal communication); adjusting language or terminology to the characteristics and needs of the audience. May also include the ability to present new ideas and concepts and articulate/support them in a reasonable manner to a critical group. Initiative: Making active attempts to influence events to achieve goals: self-starter rather than accepting passively; taking action to achieve goals beyond what is required; being proactive. Leadership: The ability to attract and mobilize energies and talents of others to work toward shared objectives of a group or organization. Encourages partnerships. Inspires others, by example to perform to the highest standards. Sets and/or involves others in setting goals that are challenging, realistic and measurable. Accepts responsibility for outcomes and is accountable. Recognizes contributions and successes of others. Problem Solving: Committing to an action after developing alternative courses of action that are based on logical assumptions and factual information and that take into consideration resources, constraints, and organizational values. Teamwork: Working effectively with a team or those outside formal line of authority (e.g., peers, senior managers) to accomplish organizational goals; taking actions that respect the needs and contributions of others; contributing to and accepting the consensus; subordinating own objectives to the objectives of the organization or team. Tenacity: Staying with a position or plan of action until the desired objective is achieved or is no longer reasonably attainable. Interpersonal Skills: The ability to interact sensitively and respectfully with all individuals and groups to develop mutual understanding and productive relationships. The candidate demonstrates empathy. Works effectively in teams and in partnerships. Identifies and resolves issues through consultation, negotiation and consensus building and/or other appropriate processes. Stress Management: Maintaining stable performance under pressure and/or opposition (such as time pressure or job ambiguity). The relieving of stress in a manner that is acceptable to the person, others, and the organization. This includes healthy lifestyle choices.

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Vision Standard Assessment

Applicant: ____________________________ D.O.B: __________________________ For employment as a Police Officer with the Royal Newfoundland Constabulary, applicants must meet the following vision standards. This form must be completed by an optometrist or ophthalmologist. All costs related to vision testing are to be incurred by the applicant. Visual Acuity Corrected vision (with glasses or contacts): Visual acuity must be at least 6/6 (20/20) in one eye and 6/9 (20/30) in the other. Uncorrected vision (without glasses or contact lenses): Visual acuity must be at least 6/18 (20/60) in each eye OR 6/12 (20/40) in one eye and at least 6/30 (20/100) in the other eye. This minimum vision acuity is required for safe performance of policing duties if glasses or contacts are lost or displaced. Field of Vision Must be at least 150 degrees continuous along the horizontal meridian and 20 degrees continuous above and below fixation with both eyes open and examined together. Depth of Perception Normal stereo vision (use of both eyes to judge distances) must be present. Stereo acuity must be a minimum of 70 seconds of arc or better on Titmus test. Colour Vision Testing Using any standardized Pseudo-Isochromatic plates (Ishihara, A-O, HRR, Dvorine). If you correctly identify all patterns presented in such tests, your colour-vision will be considered normal. If needed, further evaluation will be conducted with devices such as Farnsworth D-15 discs. If you demonstrate a colour-vision deficiency on the Farnsworth discs, you will not meet the vision standards requirements of the Royal Newfoundland Constabulary.

This is to certify that I completed an eye examination on the above named applicant. The Applicant MEETS _______ DOES NOT MEET ________ RNC Vision Standards. Can the deficiency be corrected to meet RNC Standards? YES________ NO ________ Name of Optometrist/Ophthalmologist: _______________________________________ Signature: ___________________________________ Date: _____________________

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ROYAL NEWFOUNDLAND CONSTABULARY Voluntary Employment Equity Questionnaire The Royal Newfoundland Constabulary is committed to creating a diversified workforce. Diversity encompasses other visible and non-visible characteristics including race, ability, age, culture, ethnicity, language, religion, sexual orientation and education. The RNC wishes to achieve its goal of population representation by ensuring that all future and current employees are treated fairly with respect to recruitment, selection, promotion and training opportunities. Your response will assist the Royal Newfoundland Constabulary in meeting its organizational goals.

Please check the box that applies to you:  Male  Female  Aboriginal (Status Indian, First Nation, Non-status Indian, Metis Inuit) ________________________________________________________________________  White (Caucasian, British, French, East/West European, Russian, etc) ________________________________________________________________________  Visible Minority (other than Aboriginal-non-white, in color/race regardless of place of birth e.g. Filipino, Black, Asian, Latin American etc.) ________________________________________________________________________  Other: ___________________  Prefer Not to Answer

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