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Correctional Officer Supplemental Application

Referral Information

Ad Referral

Ad Start Date

Event Referral

Event Category

Event Date

Personal Information

First Name *

Middle Name

Last Name *

Suffix

Social Security No. * 🛈

List all names you have ever used (include maiden, married, and nicknames). *

Physical Address *

City *

County *

Physical Address Line 2

State *

Zip Code *

Primary Phone *

Secondary Phone

Other Phone

I would like to receive text updates regarding my application status at the primary phone number listed above. I understand that standard messaging charges may apply, and I may choose to opt-out at any time. *

Yes

No

Driver License Number *

State issued by *

Email Address *

Have you lived outside of the United States in the past five years? *

Yes

No

If yes, please include the location and dates. *

Have you applied in the People First system at jobs.myflorida.com? *

Yes

No

Birth/Citizenship

Date of Birth * +

Sex *

Male

Female

Race *

Birth City *

Birth State *

Birth Country *

US Citizen? *

Yes

No

If yes: *

By Birth

By Naturalization

Military Service

Military experience? *

Yes

No

Service Branch *

Type of Discharge *

Dates of all periods of military service *

Institution Preference

Click here to see a map of the major institutions.

First Choice? *

Second Choice *

Documents

The documents listed below are required for determining eligibility for the position. To expedite processing, please upload documents for each item requested. Don't have all the documents now? No problem! Upload those you have. You can provide the remaining documents to your recruiter later.

photo illustrating taking a picture of a document

For better phone images...

1. Place the document on a flat surface.

2. Hold the phone horizontally, so that the image is not taken at an angle.

3. Keep fingers out of the picture.

Social Security Card

Driver License

Education Documents
(High School Diploma or Transcripts, College Transcripts)

Proof of U.S. Citizenship
(Birth Certificate, U.S. Passport, or Certificate of Naturalization)

Proof of Scheduled CJBAT (see local recruiter for details)

Name Change Documents
All legal documents related to name change (adoption, marriage license, divorce decree, etc.)

Military ID or DD-214
- For discharged service members, DD-214 (member 2 or 4) is required
- For active military, a valid Military ID is required

Arrest Reports

Court Documents Related to Criminal Charges

Form Completion

Failure to fill this form out completely and accurately may result in the elimination of your application from further consideration.

In accordance with section 119.071(5)(a)2 Florida Statutes (2021), your social security number is being collected for verification purposes. This collection is imperative for the performance of this agency’s duties and responsibilities as prescribed by law. Information submitted on the application must be verified prior to appointment. Inclusion of the social security number will save staff time and result in the position being filled with prompt efficiency. The Department will not use the social security number collected for any purpose other than the purpose provided above.

*

Acknowledged

Attestation and Submission (Read carefully before signing)

By submission of this electronic form, I hereby certify there are no misrepresentations, omissions, or falsification in the foregoing responses. I am aware that should an investigation disclose any misrepresentations, omissions, or falsifications, my application may be rejected, and I may be disqualified for employment with the Florida Department of Corrections or, if after my acceptance for employment, subsequent investigation should disclose misrepresentations, omissions, or falsifications, it may be just cause for my immediate dismissal.

*

Acknowledged

Signature *

clear

Date * +

DC2-854 Revised 11/08/2022