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2. Portsmouth Police Department
   Police Officer Application

6. Please complete all sections of this application form.  

   Upon the submission of this application, a department representative will contact you to discuss subsequent steps.

   If you wish to speak with a member of our recruitment team, please reach out to our Recruitment Coordinator, Lieutenant James Francis, at jfrancis@portsmouthri.gov.

   In accordance with Federal and State regulations, qualified applicants are considered for all positions without regard to race, color, religion, creed, national origin, age, gender, marital status, sexual orientation, veteran status, or any other legally protected status, or disabilities that do not interfere with job performance.

10. First Name*
11. Last Name*
13. Address1*
15. Address2
17. City*
18. State*
19. Zip*
21. Contact Number 1*
22. Contact Number 2
23. Email*
25. Date of Birth*
26. Driver's License State*
27. Driver's License Number*
29. Gender*
30. Race/Ethnicity*
34. 1. Are you a U.S. Citizen?*

    1. Yes
    2. No
36. 2. Are you at least 21 years of age?*

    1. Yes
    2. No
38. 3. Do you have a valid driver's license?*

    1. Yes
    2. No
40. 4. Have you ever been convicted of a felony or misdemeanor?*

    1. Yes
    2. No
42. If yes to #4, please list:
46. 5. Are you currently a certified police officer?*
    -- Select One --NoYes
48. If yes to #5:

    Please provide the following information:

    1. Where are you currently serving as a police officer?
    2. How long have you been a police officer?
    3. If you are no longer currently employed as a police officer, when did you serve, and what was the reason for your departure?
52. High School Name*
53. High School City*
54. High School State*
56. High School Graduation Date*
57. Diploma/GED Received?*

    1. Yes
    2. No

61. Please revisit our employment opportunities page to download and complete the Fitness Test Medical Certificate Form and the Fitness Test Release Form. These documents are required to participate in the department's fitness test.

    *We accept Fit 2 Serve certifications for Fitness & Written Examinations*

    
    

Leave This Blank:


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit Submit and Print

* indicates a required field