As a necessary condition of consideration for association with the Klickitat County Sheriff’s Search and Rescue unit, specific information and documents are required. Failure to provide this information will result in the removal of your application for consideration. If you have concerns about any of the questions, please put “N/A” in the blank and it can be discussed privately with an officer.
Complete the application and return it to the Sheriff’s Office with the following:
(1) Recent photograph
(2) Copy of Driver’s License
Your application will be kept on file while a background investigation is conducted. You will be notified when this is completed. The background investigation could take three months or more to complete. The following is a brief summary of the investigation process:
Criminal History check – Disqualification for any felony convictions, any misdemeanor convictions within the last five years or other convictions that cause concerns
Driver’s License check – Disqualification for excessive violations in last five years
Department Records check – Disqualification for negative contacts with Law Enforcement that cause us concerns
Interviews with references and employers
Interview with Sheriff’s Office representative
Final review and approval by the Sheriff
Thank you for your interest in joining the Klickitat County Sheriff’s Search and Rescue unit.
Address: ______________________________________________________________________
City: ____________________________ State: ____________________ Zip: _______________
Other Names you have gone by:
____________________________________________________
Home Phone: ____________________________ Work Phone: __________________________
Email Address: ___________________________________
Date of Birth: __________________ Eye Color: _______________ Hair Color: _____________
Sex: _________________________ Height: _________________ Weight:
_________________
Any driving restrictions?: _________________________________________________________
Any driving endorsements?: _______________________________________________________
Have you ever been convicted of a felony?: ___________________________________________
Do you have any physical or medical limitations?:
_______________________________________
This will not preclude
you from participating on SAR missions
Describe your availability to respond to Search and Rescue missions at odd
hours: ______________
____________________________________________________________________________
____________________________________________________________________________
Explain any Search and Rescue related training or experience. Please
provide documentation if available.:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Please list any specialized training or experience. Include any
experience in the medical field, military, Forest Service, Emergency Services,
Climbing, extended hiking, etc.: ______________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
I certify that to the best of my knowledge the above information is true and correct.
Signed: __________________________________ Date:
________________________
Please return this application to the Sheriff's Office at 205 S. Columbus Rm. 108 MS-CH-7 Goldendale, WA 98620.
Spillman Information: _____________________________ Name Number:
_________________
NCIC III/WASIC : _____________________________
Drivers Check :
_____________________________
Abstract of Driving Record:
_______________________
KLICKITAT COUNTY SHERIFF’S
SEARCH AND RESCUE
WAIVER AND AUTHORIZATION
TO RELEASE INFORMATION
To Whom It May Concern:
I authorize you to furnish the Klickitat County Sheriff with any and all information you have concerning me, including my work record, my reputation, my medical records, and my military service records. Information of a confidential or privileged nature may be included. Your reply will be used to assist the Klickitat County Sheriff in determining my qualifications and fitness for duty with the Klickitat County Sheriff’s Search and Rescue team.
I understand my rights under Title 5, United States Code, Section 5521, the Privacy Act of 1974, and I waive these rights with the understanding that information furnished will be used by the Klickitat County Sheriff’s Office in conjunction with employment procedures.
I hereby release you, your organization, and others from any liability or damage which may result from furnishing the information requested. A photocopy of this authorization shall be as valid as the original.
This authorization shall be considered valid only during my tenure with the Klickitat County Sheriff’s Search and Rescue team. After termination of my involvement with the team, this authorization shall no longer be valid.
List other names you have been known by (including maiden name and prior married names).