Volunteer Victim Advocate

AFFIDAVIT — APPLICANT ACKNOWLEDGEMENT OF TERMS AND CONDITIONS OF THIS APPLICATION. IT IS IMPORTANT THAT YOU READ THIS SECTION CAREFULLY AND THAT YOU FULLY UNDERSTAND IT BEFORE YOU SUBMIT IT. THIS SECTION AFFECTS YOUR LEGAL RIGHTS. IF YOU HAVE ANY QUESTIONS, PLEASE ASK AN ASSIGNED RECRUITER OF THE JEFFERSON COUNTY SHERIFF'S OFFICE (HEREIN REFERRED TO AS "OUR OFFICE") BEFORE YOU ACCEPT THIS APPLICATION. It is the policy of Jefferson County and the JEFFERSON COUNTY SHERIFF'S OFFICE to not discriminate on the basis of race, color, religion, creed, sex, age, national origin or disability unless related to a bona fide occupational qualification. By clicking on the 'Accept' button, you promise that all information you have supplied in this application and any other form, oral or written, is complete, true and accurate. Any misstated, misleading, incomplete, or false information is grounds for rejection of this application form, refusal to hire, withdrawal of an offer of employment, or immediate discharge without recourse, whenever and however discovered. Your promise is made with the understanding that your statements will be relied upon in the hiring process. An incomplete application will delay the hiring process. If you disagree with the statements, policies, and procedures below, you should not fill out an employment application form and should not seek employment with the JEFFERSON COUNTY SHERIFF'S OFFICE.

In the event of my appointment to a volunteer position with the JEFFERSON COUNTY SHERIFF'S OFFICE, I will comply with all rules and regulations of the office. I further understand that the office may obtain, or cause to be obtained, public records, including court records, criminal history, polygraph examination reports, Department of Motor Vehicles records, credit reports, and educational records about me as part of a background investigation and that in certain circumstances I may waive my right to receive a copy of such public records. To the extent that a background investigation is to be conducted by a third party, I understand that the applicable documentation and certification required by the Federal Credit Reporting Act and the state will be provided to me. I understand that the entire process may include post conditional testing such as psychological examination and may take up to six months to complete. After the completion of a hiring process, any applicant who is not hired is encouraged to apply for any other position within the Sheriff's Office.

I further understand that the office may contact my previous employers. I authorize those employers to disclose to the office all records and information pertinent to my employment with them. In addition to authorizing the release of any information regarding my employment, I hereby waive any rights or claims I have or may have against my former employers, their agents, employees, and representatives, educational institutions, as well as other individuals who release information to the office, and release them from any and all liability, claims, or damages that may directly or indirectly result from the use, disclosure, or release of any such information by any person or party, whether such information is favorable or unfavorable to me. I authorize the persons named herein as reference to provide the office with any pertinent information they may have regarding myself. IF YOU HAVE ANY QUESTIONS REGARDING THIS APPLICANT ACKNOWLEDGEMENT OF TERMS AND CONDITIONS OF THIS APPLICATION, PLEASE ASK AN ASSIGNED RECRUITER BEFORE ACCEPTING AND SUBMITTING THIS APPLICATION. DO NOT SUBMIT THE APPLICATION UNTIL YOU HAVE READ THE ABOVE TERMS AND CONDITIONS AND UNDERSTAND THEM. I hereby acknowledge that I have read the above terms and conditions and understand the same. I further acknowledge by clicking on the 'Accept' button below that no promise or offer of employment has been made to me at this time.

By submitting this application to participate in the VSU Volunteer Victim Advocate program, I authorize the Jefferson County Sheriff's Office to check my personal background and references and conduct other background checks for arrest records, convictions, and traffic citations as necessary to insure the integrity of the Victim Services Unit. I also declare and attest that the above information is correct to the best of my knowledge.

By checking the "I agree" box below, you agree and acknowledge that 1) your application and acknowledgment and consent to release information will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

I do solemnly, sincerely, and truly affirm and declare that:

I am presently an applicant for employment with the Jefferson County Sheriff's Office (the "JCSO"), which is located in Golden, Colorado.

I fully understand that the JCSO conducts a background investigation of all applicants (using this application for its beginning point), who are being considered for a position with the JCSO. This investigation includes, but is not limited to, an investigation of my past employment performance, school records, military, police, driving records, credit report and credit records, and character. Records may include all investigations of my conduct in any regard (to include internal affairs or professional standards investigations). I hereby waive any and all rights that I may have to examine, review, or inspect any documents or information of whatever kind, form or nature, obtained in the course of the background investigation.

I hereby authorize any person who is contacted by JCSO personnel to release any information to the JCSO pertaining to the background investigation including, but not limited to, records or information relating to my past employment performance, health, financial stability, credit records, reports, and information, schooling, military, police driving records and character for use by the JCSO in the consideration of my application for employment and for no other purpose.

I also understand hereby that this application and any and all papers and other exhibits submitted by me or any person, government agency, former employer, private business, or any other individual or group of individuals become, upon submission to the JCSO, the property of the JCSO and will not be returned to me under any circumstances whatsoever or disclosed to me, except as provided by the laws of the State of Colorado.

I authorize the JCSO to release any documents or information collected during the application process to any person or entity lawfully empowered to obtain such information or documents. As set forth in C.R.S. §§ 24-33.5-115(3) and 30-10-526(3), I further agree to release and hold harmless any state or local law enforcement agency or governmental agency, as well as its elected officials, officers, agents, and employees, for the release of such information to the JCSO from any liability and claims which I may have against that person or entity arising out of the release of such information.

I further agree to release and hold harmless the JCSO, Jefferson County, and their elected officials, officers, agents, and employees from all liability or claims which I may have arising out of the disclosure of such information to the JCSO for use by the JCSO in the consideration of my application for employment and for such other purposes as may be related to any subsequent employment with JCSO, and the disclosure or release of any documents or information by the JCSO or agents thereof collected during the application process to any person or entity lawfully empowered to obtain such information or documents.

This authorization for the release of information shall be valid for a six month period from the date hereof. All releases of claims and liability set forth herein shall survive the expiration of this authorization.

All statements made by me in the completion of this application are, to the best of my knowledge and recollection, accurate and true and I understand that any false answer or any fraud whatsoever, constitutes a basis for automatic rejection of this application, or if I am hired and fraud and/or deceit is subsequently discovered, such fraud and/or deceit will become grounds for my immediate dismissal from the JCSO.