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Professional Details

with current agency

Full civil service time (if different from above)


First Name
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Address1
Address2
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Average Frequency
Average Shift Duration
Current Pay Rate

Contractual Agreement

I hereby agree, via electronic signature, that I have read and understood all department guidelines and restrictions regarding secondary employment and code of conduct.
I do not agree to authorize my electronic signature because I have not read and understood all department guidelines and restrictions regarding secondary employment and code of conduct.

Please Click Here and read the following document detailing the Off Duty Blue Liability Statement.

I have read and understand the disclaimer of liability statement.

Individual new account

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Personal Details

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Please select your preferred department

Contractual Agreement

Please Click Here and read the following document detailing the Off Duty Blue Liability Statement.

I have read and understand the disclaimer of liability statement.

Both required

I will cooperate in the prosecution of any arrest made as a result of this employment.
This position does not require labor union affilication or permission.

Business new account

Account

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Personal Details

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Please select your preferred department

Business Details

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Contractual Agreement

Please Click Here and read the following document detailing the Off Duty Blue Liability Statement.

I have read and understand the disclaimer of liability statement.

Both required

I will cooperate in the prosecution of any arrest made as a result of this employment.
This position does not require labor union affilication or permission.

Department Administrator

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