APPLICATION FOR COMPETITIVE EXAMINATION FIRE AND POLICE CIVIL SERVICE BOARD PLEASE PRINT OR TYPE. FAILURE TO ANSWER ALL THE QUESTIONS IN THIS APPLICATION AND FAILURE TO ATTACH ALL REQUIRED DOCUMENTATION TO THIS APPLICATION MAY CAUSE YOUR APPLICATION TO BE REJECTED, NAME: RST MIDDLE LAST Kevin Tonnet Kirk [STREET ADDRESSIP.O. BOX NO. ‘om¥rrown ‘STATERIP Sulphur La. 7068 = | |poweTeerhowe sonnen cum amen 950 ‘OFFICE TELESHONE NUMBER (TH AREA CODE) () (a7 ast-14se | [CELL TELEPHONE NUMBER (WITH AREA CODE) E-MAIL ADDRESS —— as — ATE OF BIRTHE WONTHWDATETVEAR __ [pe You qomeen oF tae uNreo stares? mine [| ves No ‘xe warion Dare EXAMINATION FOR WHICH YOU ARE APPLYING (FILE A SEPARATE APPLICATION FOR EACH EXAMINATION) 1 | Chietof Potice eon ‘The Federal goverment requires that we request the following race and sex information for statistical reporting purposes, [Completion of this section Is voluntary, and your application will not be rejected if you choose net to provide this information. TAitspanie Lam. naan Dasien |_. [lvassndocs want snvcs wer you no boo ctrl te raed Sate aot ent ger ater eee oe ural rapt ct series tarin ah radeon hs sap town ann eters atch fe nope canna aes, you mit ch recnsnydocerson oat ou me ae oyna tl srs turd ech os eee ater neces ac cae a Roane ere mest sae Es PTE eee se anc reer teneaeer amare ete f | eae enema eases Sete s easenear rere of Naturatiztion) []proot thet you moet all other raqurements posted by the civil service board to be admitted to thHAVE COMPLETED THIS APPLICATION WITH THE KNOWLEDGE AND UNDERSTANDING THAT ANY OR ALL ITEMS CONTAINED HEREIN AY BE SUBJECT To| INVESTIGATION PRESCRIBED BY LAW, AND I CONSENT TO THE RELEASE OF INFORMATION CONCERNING MY CAPACITY AND FITNESS BY ENPLOYERS, |EDUCATIONAL INSTITUTIONS, LAV” ENFORCEMENT AGENCIES, ANO OTHER INDIVIDUALS AND AGENCIES. TO DULY ACCREDITED INVESTIGATORS, civ [SERVICE BOARD MEMBERS AND OTHER AUTHORIZED EMPLOYEES OF THE GOVERNMENT FOR THAT PURPOSE, | CERTIFY THAT THE ANSWERS | HAVE GIVEN TO ALL QUESTIONS IN THIS APPLICATION ARE TRUE TO THE BEST OF MY KNOWLEDGE. | KNOW THAT ANY] MISREPRESENTATION HEREIN MAY CAUSE MV APPLICATION TO BE REJECTED, MY NAME REMOVED FROM THE ELIGILE UST ANOVOR MAY SUBJECT ME TO| IsMISSAL FROM EMPLOYWENT. B-16-18 WITHIN THE PAST 5 YEARS, HAVE YOU BEEN TERMINATED, OR RESIGNED IN LIEU OF TERMINATION, FROM ANY POSITION FOR REASONS OTHER THAN A REDUCTION IN FORCE? vesL] 2 oat YOU BE REN CONMCTED OF AELONT ves] vesL] NOTE: IF YOU ANSWERED "YES" TO EITHER OF THE ABOVE QUESTIONS, PLEASE PROVIDE AN EXPLANATION IN THE EXPLANATION BLOCK BELOW. A CONVICTION WiLL NOT NECESSARILY CISQUALIFY YOU FROM THE JOB FOR WHIGH YOU ARE APPLYING, A CONVICTION WILL BE JUDGED ON IT OWN, MGRITS WITH RESPECT TO TIME, CIRCUMSTANCES, AND SERIOUSNESS. page 2 of 7MoNoose Stato University A. HIGH SCHOOL ae 08 aber Lagrange High Schoo! Lagrange High Schoo! orton on sauvAenoY caRnsATE 3420 Loulsiana Ave. ‘ore neceven.05/23/1988 Lake Charles La.70801 Bachalor | 42/45/2004 | Gen.Studies ©, OTHER FORMAL TRAINING a ae __ | vaness, rane, uturany, er, c-sses on Seas) aa © | rms or mermucton on css ATTACH ADOTIONAL PACES IF NECESSARY) FBI Natlonal Acaderny Quantico Va. Ar 40 POST Basic Certficate- Lake Charles La. a 40 Le ___. LE i y [PLEASE IST BELOW AIY PROFESSIONAL UIGENSES OR CERTINGATIONS THAT AR RELEVANT TO THE JOB FOR WHIGH YOU ARE APPLYRG. ere soomesu nes ects) y E iS BA /| POST Basic Certificate FBI National Academy FBI- Executive Leadership come eet {a ay on =e en tes i aed) 09/14/2008 8/04/2017 page bor