Passport sized

Photograph

APPLICATION FOR ENLISTMENT IN THE

JAMAICA POLICE SERVICE

The aim of the JCF recruitment policy is to recruit suitable and qualified individuals to become a
part of the organization. We are seeking individuals who are professionals with high moral
standards and integrity. They should be loyal, hardworking and committed.

 Please complete this form in your own handwriting in BLOCK CAPITALS using a black or blue ink pen.

 Sections which do not apply to you should be clearly marked Not Applicable.

 Have you completed an online application form? If yes, please give application
number________________________

 Please use page 6 for additional information where the space provided is inadequate.

Date of application: _______/ ________/_________

yyyy MM DD

Recruiting Centre: (Tick the appropriate box) May Pen St.Mary Montego Bay Kingston

Applying to become a member of the: JCF Rural Police (D/C).

SECTION A PERSONAL DETAILS

LAST NAME FIRST NAME MIDDLE NAME

ALIAS (ES) GENDER M F MARITAL STATUS SINGLE MARRIED DIVORCED OTHER

AGE RELIGION/ DENOMINATION

DATE OF BIRTH PLACE OF BIRTH PARISH OF BIRTH

(YY/MM/DD)

NATIONALITY NATIONALITY BY: BIRTH REGISTRATION NATURALIZATION

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PRESENT ADDRESS

STREET ADDRESS (INCL. STREET NUMBER) POST OFFICE BOX DISTRICT

VICINITY:(e.g. Near Mass Joe Blue Shop) PARISH COUNTRY OF RESIDENCE

TELEPHONE: HOME: CELL: WORK: EMAIL ADDRESS:

DISTINGUISHING MARK DETAILS

Do you have any distinguishing marks e.g. Birthmarks? Yes No. If yes, describe their nature and location.

Do you have any tattoo(s) on your arms, neck, or face? Yes No. If yes, describe their nature and location.

PREVIOUS ADDRESSES (INCLUDING RESIDENCE OVERSEAS)

PERIOD RESIDED
ADDRESS (INCL. STREET NUMBER) POSTAL ADDRESS PARISH COUNTRY (FROM TO)

EMERGENCY CONTACTS
Names of persons to be contacted in case of emergency.
NAMES RELATIONSHIP FULL ADDRESS(ES) TEL. NO/ EMAIL ADDRESSES (JAMAICA ONLY)

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OVERSEAS TRAVEL
ENTER PARTICULARS OF EVERY COUNTRY VISITED ABROAD.
COUNTRY DATE DATE PURPOSE OF FULL ADRESS(ES) STAYED NAME OF HOST /
DEPARTED RETURNED TRAVEL OVERSEAS HOSTESS

GENERAL EDUCATION (GP only)

YEARS EXAMS PASSED
HIGH SCHOOLS ATTENDED (CSEC, CXC, SUBJECTS AND PASSING YEAR
(including parish) FROM TO GCE, CAPE, PROFICIENCY GRADES TAKEN
ETC.)

FURTHER EDUCATION (TERTIARY)

DEGREE, DIPLOMA ,
NAME OF INSTITUTION ADDRESS CERTIFICATE DISCIPLINE YEAR ATTENDED
FROM TO

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 FOREIGN LANGUAGE COMPETENCY
FOREIGN LANGUAGE LEVEL(BASIC, INTERMEDIATE, SPECIAL SKILLS (COMPUTING, AUTO-MECHANIC,
ADVANCED) NURSING, ETC).

SECTION B FAMILY DETAILS

ADDRESS (INCLUDING
RELATIONSHIP FULL NAME AGE PARISH) OCCUPATION
SPOUSE/PARTNER

FATHER

MOTHER

GUARDIAN/SPONSOR

BROTHER(S)

SISTER(S)

CHILDREN
FULL NAME AGE ADDRESS (INCLUDING PARISH) OCCUPATION

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 DEPENDENTS DETAILS OTHER THAN THOSE STATED ABOVE
NAME(S) AGE ADDRESS (incl. parish) RELATIONSHIP EXTENT OF DEPENDENCE

PARTICULARS OF FRIENDS/CLOSE ASSOCIATES

NAMES (incl. aliases) AGE ADDRESSES (incl. parish) OCCUPATION TELEPHONE No.

SECTION C EMPLOYMENT DETAILS (START WITH THE MOST CURRENT JOB).

NAME OF COMPANY/ WORK PRESENT POSITION TEL. NO./EMAIL DATES REASON(S) FOR
EMPLOYER ADDRESSES Or CAPACITY WHICH ADDRESS FROM TO LEAVING
EMPLOYED

LIST AGENCIES TO WHICH RECENT JOB APPLICATION HAVE BEEN MADE IN THE LAST 18 MONTHS
NAME OF COMPANY/AGENCY POSITION APPLIED STATUS OF APPLICATION (IF KNOWN)

HAVE YOU PREVIOUSLY APPLIED FOR ENTRY TO THE POLICE/MILITARY SERVICE? IF YES, GIVE DETAILS OF DATE AND RESULTS
DATE OF APPLICATION EXAMINATION CENTRE RESULT/OUTCOME OF APPLICATION

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PREVIOUS GOVERNMENT SERVICE
HAVE YOU EVER SERVED IN THE MILITARY, POLICE, CUSTOMS, IMMIGRATION OR CORRECTIONAL SERVICES ETC (LOCALLY
/ABROAD)? GIVE DETAILS.
NAME OF ORGANIZATION LAST POSITION HELD DATES
FROM TO

REASON FOR DISCHARGE OR

SEPARATION.

COMMUNITY SERVICE
CIVIC, COMMUNITY GROUPS AND SERVICE CLUB: GIVE STATUS AND PERIOD OF MEMBERSHIP. STATE REASON FOR LEAVING IF
MEMBERSHIP HAS BEEN TERMINATED.

BUSINESS INTEREST (ASSETS, LIABILITIES)

STATE YOUR BUSINESS INTEREST(S) INCLUDING NAME OF COMPANY, ADDRESS, OWNERSHIP, POSITION, SHAREHOLDING,
MANAGERIAL POSITION HELD ETC.

REFERENCES: GIVE THE NAMES AND ADDRESSES OF TWO REFEREES

REFERENCE # 1 REFERENCE # 2 REFERENCE # 3

NAME / TITLE

ADDRESS

PERIOD KNOWN BY
REFEREE
TEL. NO OF
REFERENCE
OCCUPATION

EMAIL ADDRESS

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ARRESTS CONVICTION AND CAUTIONS (LOCALLY AND ABROAD)
PLEASE TICK THE APPROPRIATE ANSWER
LOCALLY ABROAD
YES NO YES NO

HAVE YOU EVER BEEN ARRESTED OR DETAINED BY THE POLICE?

HAVE YOU EVER BEEN THE SUBJECT OF ANY CRIMINAL
INVESTIGATIONS?

HAVE YOU EVER BEEN SUMMONED FOR ANY OFFENCE?

HAVE YOU EVER BEEN CHARGED FOR ANY OFFENCE?

HAVE YOU EVER BEEN CONVICTED FOR ANY OFFENCE?

HAVE YOU EVER BEEN WARNED OR CAUTIONED BY THE POLICE?

HAVE YOU EVER BEEN TICKETED FOR ANY OFFENCE?

HAVE YOU EVER BEEN TAKEN BEFORE A CIVIL COURT?

IF YOU HAVE ANSWERED YES, PLEASE ENTER DETAILS BELOW

DATE OFFENCE/ ALLEGATIONS COURT/POLICE STATION INVOLVED RESULTS (IF KNOWN)

ILLEGAL DRUG USE YES NO

NAME OF SUBSTANCE(S) USED LAST TIME SUBSTANCE WAS USED WHY

I have completed this form on my own free will knowing that if I wrote any false
information or failed to disclose information that is required, I will be disqualified from
entry to the Police Service, or if discovered at a later date even after my appointment, it
will lead to my summary dismissal. I also fully understand and accept that the
recruiting process is CONFIDENTIAL and the Commissioner of Police may refuse my
application without giving any reason.

SIGNATURE OF APPLICANT______________________________ DATE __________________

SUB- OFFICER IN CHARGE ______________________________ DATE __________________
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 OFFICIAL USE ONLY

SECTION D (TO BE COMPLETED BY RECRUITING OFFICER)

Result of Written (entry) Examination PASSED FAILED

Height: FT/CM Weight: LBS/KGS

Chest measurement: INCH/CM

NIS # TRN

BIRTH CERTIFICATE # PLACE OF BIRTH: DATE OF BIRTH:

PASSPORT # PLACE OF ISSUE: EXPIRY DATE:
DRIVERS LICENCE # PLACE OF ISSUE: EXPIRY DATE:
VOTERS ID # DATE OF ISSUE: EXPIRY DATE:

COPIES OF DOCUMENTS RETAINED

COMMENTS:____________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

NAME RANK AND No. OF RECRUTING SUB-OFF:______________________________DATE____________

SECTION E
TO BE COMPLETED BY THE FACULTY OF RECRUITING AND PROBATIONARY TRAINING OFFICE
ANTECEDENT REPORT
SATISFACTORY ISSUES FOR CLARIFICATION UNSATISFACTORY

SECURITY CHECKS SATISFACTORY UNSATISFACTORY INCONCLUSIVE

NAT. INTEL. BUREAU
NARCOTICS/TCND
FINGERPRINT/CRO
N.B. ALL INCONSISTENCIES OBSERVED/DISCOVERED SHOULD BE STATED FOR FURTHER PROBING DURING INTERVIEW.

INTERVIEW RESULT
SUITABLE UNSUITABLE

COMMENTS:
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

SUB-OFFICER I/C CENTRAL RECRUITING OFFICE:

NAME_______________________________________ DATE__________________

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MEDICAL RESULTS SATISFACTORY UNSATISFACTORY INCONCLUSIVE
MEDICAL EXAMINATION
BLOOD TEST
CHEST X-RAY
URINE ANALYSIS
PHYSICAL EXAMINATION
EYE TEST PASS FAIL
COMMENT ON SUITABILITY OF INDIVIDUAL FOR ENLISTMENT IN THE POLICE SERVICE.
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________

NAME OF MEDICAL OFFICER……………………………………………………………

SIGNATURE ………………..………………………………………
DATE ………………………………….

OFFICER DOING FINAL VETTING:

NAME __________________________________________

SIGN ____________________________________
DATE __________________________________________

TO BE FILLED OUT BY MEMBERS OF THE SELECTION PANEL

FINAL DECISION OF SELECTION BOARD DATE OF BOARD MEETING (YY/MM/DD

ACCEPTED REJECTED

REASON FOR REJECTION

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

NAMES AND SIGNATURES OF BOARD MEMBERS:

CHAIRMAN: _____________________________________________

MEMBER: _____________________________________________

MEMBER: _____________________________________________

MEMBER: _____________________________________________
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