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Introduction

Instructions
Applications are only accepted after a “Notice of Exam” has been posted.

You must attach a copy of the following: High School Diploma or G.E.D.; Certificate DD 214 (if served in military); Social Security Card; Driver’s License; Birth Certificate; Certification of Fire Fighter Basic issued by Texas Commission on Fire Protection Personnel Standards and Education; and Basic Emergency Medical Technician Certification from Texas Department of State Health Services.

Failure to provide requested documents and/or failure to return application to the civil service director by posted deadline will result in your application being rejected.

Please note the time and date on the “Notice of Examination” for the deadline of application being rejected. Any documents which are expired will not be accepted.
Detailed Instructions
Application Instructions (PDF)
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Applicant Qualification

Qualifications
1. I am a citizen of the United States of America.
2. I have earned a high school diploma or a GED.
3. I have never been convicted, plead guilty (nolo contendere), nor have I been on court- ordered community service/probation or deferred adjudication for a Class A misdemeanor or a felony.
4. During the last 10 years, I have not been convicted, plead guilty (nolo contendere), been on community service/probation or deferred adjudication for a Class B misdemeanor in this state or other.
5. I have never had a military court martial that resulted in a dishonorable or bad conduct discharge.
6. I do not meet these qualifications.
Before you begin to fill out this application, please ensure that you meet the following requirements. You must meet all 5 of these requirements to qualify for licensure as a peace officer in Texas.
Disqualification
There are very few automatic basis for rejection. Even issues of prior misconduct, employee terminations, and arrests are usually not, in and of themselves, automatically disqualifying. However, deliberate misstatements or omissions can and often will result in your application being rejected, regardless of the nature or reason for the misstatements/omissions. In fact, the number one reason individuals “fail” background investigations is because they deliberately withhold or misrepresent job-relevant information from their prospective employer.

This application form is a governmental document. Be truthful, as there are criminal consequences for lying on a governmental document.
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Basic Information

Disclaimer

Application Agreement
In completing and signing this application for employment, I understand that misrepresentation or omission of facts is cause for cancellation of this application or separation from the City’s service if I am employed. I agree that the City shall not be liable in any respect if my employment is terminated because of the falsity of statements, answers or omissions made by me on this application.

In connection with my application for employment, or if I am offered employment, at any time during my employment, the City may conduct an investigation of me as part of the process of considering my candidacy as an employee or as deemed necessary during my employment. I understand that the investigative report may include among other things, information as to my character, general reputation, criminal history, personal characteristics, and previous employment history. This information may be obtained by contacting, among others, my previous employers or references supplied by me. I hereby release from all liability or damages the City of Brownwood and those individuals, corporations, or organizations, who provide such information. I understand any such information provided shall become the exclusive property of the City of Brownwood.

All employees of the City of Brownwood are employees at will and, as such, are free to resign at any time. The City of Brownwood also retains the right to terminate any employee’s employment at any time.

This application is current for only 30 days. At the conclusion of this time, if I have not heard from the City of Brownwood and still wish to be considered for employment, it will be necessary for me to fill out a new application.
How were you referred to the civil service exam?
1. Employee
2. Advertisement
1. School
2. Drop In
1. Website
2. Other
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Personal Information

Current Address
Address1
Address2
City
State
Zip
Phone Number
Email
Previous Address
During the last 10 years beginning with most recent. If you lived out of state, please provide full address including zip code. Include military assignments. (No TDY’s temporary assignments)
Address1
Address2
City
State
Zip
Address1
Address2
City
State
Zip
Address1
Address2
City
State
Zip
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Marital & Family History

Employment Record

Job History
Beginning with the most recent, list below jobs held now and in the past. Also list any other experience related to the position for which you are applying. Include military and volunteer work. Please give valid contact numbers on information for each employer .this section must be filled out completely even if attaching a resume.
If you are currently employed, may we contact your present employer?
1. Yes
1. No
Name of Company
Position Held
Address1
Address2
City
State
Zip
Type of Business
Department Assigned
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Salary
List starting and ending salary.
Name & Title of Supervisor
Phone Number
Name of a Coworker
Phone Number
Job Description
Describe in detail the work you did, equipment operated, skills employed.
Identify Any Disciplinary Action
Reason for Leaving
Name of Company
Position Held
Address1
Address2
City
State
Zip
Type of Business
Department Assigned
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Salary
List starting and ending salary.
Name & Title of Supervisor
Phone Number
Name of Coworker
Phone Number
Job Description
Describe in detail the work you did, equipment operated, skills employed.
Identify Any Disciplinary Action
Reason for Leaving
Name of Company
Position Held
Address1
Address2
City
State
Zip
Type of Business
Department Assigned
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Salary
List starting and ending salary.
Name & Title of Supervisor
Phone Number
Name of Coworker
Phone Number
Job Description
Describe in detail the work you did, equipment operated, skills employed.
Identify Any Disciplinary Action
Reason for Leaving
Name of Company
Position Held
Address1
Address2
City
State
Zip
Type of Business
Department Assigned
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Salary
List starting and ending salary.
Name & Title of Supervisor
Phone Number
Name of Coworker
Phone Number
Job Description
Describe in detail the work you did, equipment operated, skills employed.
Identify Disciplinary Action
Reason for Leaving
Was there an unemployment period (if any) between previous employment?
Was there an unemployment period (if any) between previous employment? Start Date
—
Was there an unemployment period (if any) between previous employment? End Date
If yes, please explain.
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Driving Information

Identify all vehicles that you currently own or operate.
Include year, make, model, color, license plate number, and owner.
Licenses
List all driver licenses ever held. This section must be completed by all applicants.
License Type
State
License Number
Expiration Date
Expiration Date
Restrictions
License Type
State
License Number
Expiration Date
Expiration Date
Restrictions
License Type
State
License Number
Expiration Date
Expiration Date
Restrictions
Driving Experience
Completion of this section is required if you are applying for a position that involves driving a City vehicle.
How many years have you been driving?
How many years driving an employer's vehicle?
How many years driving a passenger vehicle?
How many years have you driven commercially?
Can you drive a clutch operated transmission vehicle?
Do you have a current driver's license?
1. Yes
2. No
License Type
1. Class A
2. Class B
3. Class C
List Commercial Driver's License Endorsements
Has any license you have ever held been:
1. Suspended
2. Revoked
If yes, when?
If yes, when?
For how long?
For how long? Start Date
—
For how long? End Date
Why?
In what states?
Do you have any other driving experience?
What size vehicle(s)?
Length & Type of Vehicle
List the length of time driven together with type of vehicle driven.
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Accident Record

How many accidents have you ever been involved in, regardless of severity?
How many as an operator of a commercial vehicle?
How many as an operator of private cars?
Date of Last Accident
Date of Last Accident
City & State
Brief Description
Police Report? Provide report number if available.
Date of Next Previous Accident
Date of Next Previous Accident
City & State
Brief Description
Police Report? Provide report number if available.
Date of Next Previous Accident
Date of Next Previous Accident
City & State
Brief Description
Police Report? Provide report number if available.
Date of Next Previous Accident
Date of Next Previous Accident
City & State
Brief Description
Police Report? Provide report number if available.
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Traffic Violations

Date of Violation
Date of Violation
Type of Violation
Name & Location of Court
Date of Conviction
Date of Conviction
Disposition & Fine
Date of Violation
Date of Violation
Type of Violation
Name & Location of Court
Date of Conviction
Date of Conviction
Disposition & Fine
Date of Violation
Date of Violation
Type of Violation
Name & Location of Court
Date of Conviction
Date of Conviction
Disposition & Fine
Date of Violation
Date of Violation
Type of Violation
Name & Location of Court
Date of Conviction
Date of Conviction
Disposition & Fine
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Education

Arrests, Detentions, & Litigation

Have you ever been arrested or detained by law enforcement?
1. Yes
2. No
Agency
Offense
Location
Date/Time
Date/Time
Date/Time
Outcome
Agency
Offense
Location
Date/Time
Date/Time
Date/Time
Outcome
Any Other Arrest Details
Have you ever committed an act of family violence? If yes, please explain.
“Family violence” means an act by a member of a family or household against another member of the family or household that is intended to result in physical harm, bodily injury, assault, or sexual assault or that is a threat that reasonably places the member in fear of imminent physical harm, bodily injury, assault, or sexual assault, but does not include defensive measures to protect oneself. (Texas Family Code Section 71.004)
Have you ever assaulted another person since the age of 17? If yes, please explain.
"Assault” means to cause bodily injury to another, threaten another with imminent bodily injury, or to cause physical contact with another when the person knows or should reasonably believe that the other will regard the contact as offensive or provocative. (Texas Penal Code Section 22.01)
Have you ever been considered or named a suspect in a criminal investigation or criminal offense? If yes, explain.
Have you ever been a party to a civil suit or action? If yes, explain.
Have you ever been involved in any incident (do not include vehicular accidents) in which a police report was made or law enforcement was called? If yes, explain.
Other than crimes that would have been sealed by juvenile records, have you ever committed - or assisted another person in the commission of - a felony crime, serious misdemeanor, or a crime involving moral turpitude that went undetected or unreported to law enforcement? If yes, explain.
Do you anticipate being sued or named in any type of lawsuit or proceeding? If yes, please explain.
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Family & Relatives' Arrests

Have members of your immediate family or close relatives have ever been arrested?
1. Yes
2. No
Name/Relation
Charge/Offense
Agency
Date
Date
Outcome
Name/Relation
Charge/Offense
Agency
Date
Date
Outcome
Name/Relation
Charge/Offense
Agency
Date
Date
Outcome
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Financial History

Your Current Net Monthly Income
Spouse's Current Net Monthly Income
Source
Amount
Frequency
Source
Amount
Frequency
Source
Amount
Frequency
Do you have any accounts with a financial institution?
1. Yes
1. No
Name(s) of Financial Institution(s)
Type(s) of Account(s)
Credit History
Identify any person or entity to whom you are indebted, and the extent of your indebtedness. Include mortgages, vehicle payments, charge accounts, credit cards, loans, child support payments, and any other debts or payments.
Name of Creditor
(e.g., Sears, CitiFinancial)
Type of Debt
(e.g., student loan, automobile)
Monthly Payment
Approximate Balance
Name of Creditor
Type of Debt
Monthly Payment
Approximate Balance
Name of Creditor
Type of Debt
Monthly Payment
Approximate Balance
Name of Creditor
Type of Debt
Monthly Payment
Approximate Balance
Are you more than 30 days late paying any of these debts?
1. Yes
1. No
If yes, please explain.
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Credit Information

MIlitary Obligation

Are you a U.S. military service member?
Dates of Service
Dates of Service
Highest Rank Held
Branch of Service
Unit
Job Title
Type of Discharge
Last Duty Station
Have you ever been subject to court martial or any other disciplinary proceeding under the Uniform Code of Military Justice?
Include non-judicial, Captain's mast, etc. If "Yes," provide date(s), charge(s), military court(s) or authority(ies), and outcome(s)
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Personal References

First Name
Last Name
Address1
Address2
City
State
Zip
Home Phone
Work Phone
Relationship
Years Known
Years Known Start Date
—
Years Known End Date
First Name
Last Name
Address1
Address2
City
State
Zip
Home Phone
Work Phone
Relationship
Years Known
Years Known Start Date
—
Years Known End Date
First Name
Last Name
Address1
Address2
City
State
Zip
Home Phone
Work Phone
Relationship
Years Known
Years Known Start Date
—
Years Known End Date
First Name
Last Name
Address1
Address2
City
State
Zip
Home Phone
Work Phone
Relationship
Years Known
Years Known Start Date
—
Years Known End Date
First Name
Last Name
Address1
Address2
City
State
Zip
Home Phone
Work Phone
Relationship
Years Known
Years Known Start Date
—
Years Known End Date
Identify below any employees of the City of Brownwood with whom you are acquainted.
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Qualifications, Skills, & Memberships

Special Licenses
Identify any special licenses you hold (e.g., pilot, radio operator).
Foreign Language
Proficiency
1. Understanding
2. Speaking
1. Reading
2. Writing
List any specialized machinery or equipment, which you can operate.
Membership in Organizations
List past and present memberships, name, address, type, and dates of involvement.
Have you ever been an officer or a member of, or made a contribution to, an organization that advocates or practices the commission of acts of force or violence to discourage others from exercising their rights under the U.S. Constitution or right granted by law?
1. Yes
2. No
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Personal Declarations

Describe in your own words the frequency and extent of your use of intoxicating liquors.
Have you ever used marijuana or hashish? If yes, explain.
Have you ever used any illegal drug (including a performance-enhancing steroid) not prescribed by a physician? If yes, explain
Explain how often, when last used, and provide an explanation.
Have you ever sold or furnished controlled substances or prescription drugs to anyone? If yes, explain.
Are there any incidents in your life, or details not mentioned herein, which may influence this department’s evaluation of your suitability for employment as a police officer? If yes, explain.
Have you ever been employed by or applied with or served as a Reserve or Volunteer with any other law enforcement agency?
1. Yes
2. No
Do not include those listed in “Employment History” section.
If yes, please identify to the best of your knowledge.
Include agency name, address, dates, and result.
Identify any additional information you think should be considered in your application for the position you are seeking, and/or any further explanation of answers to previous questions.
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Acknowledgement

Applicant Online Signature
I hereby certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Date
Date
Information Release
Waiver (PDF)
Use this waiver form to release confidential information from previous employers, landlords, etc. to assist in your application package.
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DPS Computerized Criminal History (CCH) Verification

Applicant Name
I have been notified that a computerized criminal history (CCH) verification check will be performed by accessing the Texas Department of Public Safety Secure Website and will be based on name and DOB information I supply.

Because the name based information is not an exact search and only fingerprint record searches represent true identification to criminal history, the organization (as listed below) conducting the criminal history check is not allowed to discuss any information obtained using this method, therefore the agency may offer the opportunity to have a fingerprint search performed to clear any misidentification based on the name search, if the search provides a criminal report I know could not be mine.

For the fingerprinting process I will be required to submit a full and complete set of my fingerprints for analysis through the Texas Department of Public Safety AFIS (automated fingerprint identification system). I have been made aware that in order to complete this process I must have the correct fingerprinting (FAST) form from this agency, make an online appointment, submit a full and complete set of my fingerprints, and pay a fee of $24.95 to the fingerprinting services company, L1Enrollment Services.

Once this process is completed and the agency receives the data from DPS, the information on my fingerprint criminal history record may be discussed with me.
Agency Requirement
This copy must remain on file by your agency. Required for future DPS Audits.
Online Applicant Signature
Date
Date
Agency Name
Agency Representative
Date
Date
CCH Report Printed
1. Yes
2. No
Hired?
1. Yes
2. No
Date Printed
Date Printed
Date Destroyed
Date Destroyed
Date Destroyed
Initial
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Equal Employment Opportunity Disclosure

Submit

Submission
Submit printed form to:
P.O. Box 1389
Brownwood, Texas 76804

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Fire Civil Service Application

Steps

Introduction

Applicant Qualification

Basic Information

Disclaimer

Personal Information

Marital & Family History

Employment Record

Driving Information

Accident Record

Traffic Violations

Education

Arrests, Detentions, & Litigation

Family & Relatives' Arrests

Financial History

Credit Information

MIlitary Obligation

Personal References

Qualifications, Skills, & Memberships

Personal Declarations

Acknowledgement

DPS Computerized Criminal History (CCH) Verification

Equal Employment Opportunity Disclosure

Submit

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