City of Jacksonville
Disabled Services Division
                                                        Volunteer Application
Application for membership as an Auxiliary Parking Enforcement Officer

 
 
 
 
 
 
 
 
 
 
 
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Personal References
                                        

Work Experience
 
 
 
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Have you ever pleaded "nolo contendere" to or been convicted or found guilty of a felony?

If yes, please explain:

(Please give date, nature or offense and disposition)

It is mandatory that everyone must attach a medical statement from your doctor declaring that participation as a Title III Support Officer will not adversly affect your health.

I verify that all information given in this application is true to the best of my ability. I authorize contact of listed references. I understand that misrepresentation or omission of facts requested is cause for non-appointment as a City of Jacksonville volunteer or for termination after appointment.

 
 
 
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The City of Jacksonville encourages persons with disabilities to participate in its programs and activities. Requests for an accommodation should be submitted to the Disabled Services Division within a reasonable amount of time by contacting:
Kevin McDaniel
904-630-4940 (Phone)
904-630-4933 (TTY)
bmeyer@coj.net