SCHOOL CROSSING GUARD (50-18-SCG-001) Salary $12.77 Hourly Location Various Locations Throughout Prince George's County, MD Job Type Part-time/Permanent/Classified Department Police Department Job Number PSI 50-18-SCG-001 Closing 12/31/2018 5:00 PM Eastern Nature and Variety of Work ONLY ONLINE APPLICATIONS WILL BE ACCEPTED FOR PUBLIC SAFETY POSITIONS. PERMANENT PART-TIME The Police Department is seeking qualified applicants to fill multiple permanent part-time School Crossing Guard positions, grade X-3 in the Special Operations Division. This is specialized work in the control of traffic, both vehicular and pedestrian, in conjunction with the movement of students to and from school. These positions require employees to be available to report to various school crossing areas in the County on short notice. Applicants MUST be able to work between the hours of 7:00 a.m. - 9:30 a.m. and 1:45 p.m. - 5:00 p.m. Work is performed independently with periodic breaks by Police Officers or Supervisors at the crossing where assigned. The complexity of the work revolves around observing traffic and conditions, grouping pedestrians, stopping traffic and restarting traffic. Employees wear a uniform and work requires employees to stand, walk and use arm/hand signals, whistles, voice and flags/flares. Examples of Work Incumbents control vehicular and school bus traffic; direct students to assure conformance to traffic regulations; report traffic hazards and flagrant traffic violations to the police; obey traffic flow and conditions; wait for natural breaks, or create effective breaks, in traffic to move pedestrians safely across the street; instruct students in safe and correct way to cross the street and in ways to identify hazards. Minimum Qualifications High School diploma or equivalent G.E.D. An equivalent combination of education or experience will also be considered. Additional Information Please note - using a mobile device, such as a phone or tablet, to complete this application is NOT recommended. You are highly encouraged to use a desktop or laptop computer so that you can carefully and thoroughly read and understand all aspects of applying for this position. ELIGIBILITY TO WORK Under the Immigration Reform and Control Act of 1986, an employer is required to hire only U.S. citizens and lawfully authorized alien workers. Applicants who are selected for employment will be required to show and verify authorization to work in the United States. THE SELECTION PROCESS : Applicants must successfully complete a background investigation to be considered for the position: The background process consists of successfully completing the following: Submit an online application Preliminary Application and Applicant History Review Attend Preliminary Screening Preliminary Documents and Records Check If sufficient vacancies exist, applicants at this stage may be contacted to continue into the Background Investigation Process, which includes: Complete and Submit the Personal History Statement (PHS) Initial Interview Background Investigation Drug Screen Medical Exam Final Offer of Employment Reasons for disqualification may include (but are not limited to) the following : poor work history; poor driving record; felony conviction; illegal drug usage, possession, distribution, sale or purchase; falsification of application or other documents; failure to meet physical standards; and/or any other disqualifying factor as determined by the Police Department. CONDITIONS OF EMPLOYMENT : Must be at least 21 years old at time of appointment. Must pass vision and hearing test based on Police Department's standards. Must be willing to work in various locations within the County. Must be able to respond to a job site within thirty (30) minutes of being notified. In the position of School Crossing Guard, timing is critical. You must report to your assignments on time and stay for the full duration. Lives depend on it. Must have means of receiving and returning phone calls within ten (10) minutes. Must be willing to work in inclement weather and/or other adverse conditions. Must be willing and able to wear issued uniform. Must possess and maintain a valid driver's license and own reliable transportation. CLOSING DATE: Applications must be submitted online by 5:00 PM Eastern Standard Time (EST) on December 31, 2018. Prince George's County Government is an Equal Opportunity/Affirmative Action Employer Committed to Diversity in the Workplace General Plan Information: The Prince Georges County benefits plan year is from January 1 to December 31. A spouse (to include a same sex spouse) can be added to the health benefit plans. A marriage certificate and social security number is required to add a spouse. Children under the age of 26 are eligible for coverage under the health benefit plans. This includes stepchildren and children of the same-sex spouse. A birth certificate(s) and social security number(s) is required to add a child(ren). If you are only adding the stepchildren or child(ren) of a same-sex spouse, you will need to submit a marriage certificate. You will also need to submit the birth certificate of the child(ren) and your spouse must be listed as a parent. The premiums for health benefits are deducted on a pre-tax basis with the exception of Long-Term Disability, Extra Life Insurance and Voluntary Benefits (Short-Term Disability, Whole Life Insurance, Critical Illness, Accident Insurance, Cancer Indemnity, Hospital Indemnity Protection, Accident Indemnity Plan, Supplemental Dental and Group Legal Services). New employees must enroll in the Countys health benefit plans within thirty (30) days of the hire date. The effective date of the health benefits coverage is the beginning of the month following a waiting period of forty-five (45) days from the date of hire. After enrolling in the Countys benefit plans, employees may only make changes to the plans either during the open enrollment period, which occurs annually (usually each October), and/or during the year, due to a family status change (i.e., marriage, births, divorce and adoption). Employees must complete an Enrollment Form and provide necessary documents within thirty (30) days of any family status change. For births, please do NOT wait until you receive the birth certificate and/or social security number to enroll. Upon receipt of the previously stated documents, you can bring or mail them to the Benefits Administration Division (Division). The Division is located at 1400 McCormick Drive, Suite 245, Largo, MD, 20774. NOTE: Medical, Dental, Prescription and Vision are separate benefit plans, which are administered by separate plan administrators. Medical Plan Coverage: Health Maintenance Organization (HMO) Plans: The two (2) HMO plans that are offered through the County are Cigna Healthcare (Cigna) Open Access Plus In-Network (OAPN) HMO, 1-800-244-6224 and Kaiser Permanente , (301) 468-6000. These plans offer preventive health care services through a network of providers and health care centers. The Countys HMO plans do not include coverage for prescription, dental and vision benefits. It only covers medical health benefits. The Cigna plan is an open access network medical plan and there is no requirement to select a Primary Care Physician (PCP) or obtain a referral to a specialist. The Kaiser Permanente HMO plan requires their members to see doctors who are located in the various Medical Centers throughout the Washington Metropolitan area. There are no deductibles and claim forms under the Kaiser Permanente HMO plan. The Cigna plan has a $50 individual annual deductible for certain in-network services that must be met each calendar year prior to any plan coverage. The co-payments for office visits, laboratory services and x-rays and other services range from $0 to $35 for Cigna and Kaiser Permanente. Please see the Summary of Benefits to determine the applicable co-payments for services. The Kaiser Permanente co-pay for emergency room services is $50 and $100 co-pay for each in-patient hospital admission. The Cigna plan co-pay for emergency room services is $150 and it is a $50 co-pay for urgent care services. Additionally, the Cigna plan co-pay for out-patient hospital is $100 and $250 co-pay for each in-patient hospital admission. Medical services are also available through the Convenience Care Clinics (Minute Clinics) under the Cigna plan for certain medical conditions. The co-pay to use the clinic is $30. Please contact Cigna for a list of Convenience Care Clinics. Any non-emergency in/outpatient procedure requires precertification that must be authorized by your health plan. Open Access Plus Preferred Provider Organization (OAP) PPO Plan: The PPO plan is administered by Cigna . This plan offers the convenience and cost savings of HMO-type (in-plan) benefits along with the freedom and flexibility of out-of-plan benefits. Please see previous section on HMO plan features for information on the in-plan benefits . The out-of-plan benefits enable you to access specialists or hospitals of your choice. This plan allows employees to use non-participating providers; however, a deductible, coinsurance and any amounts over the usual and customary fee will apply. The out-of-plan benefi t has a $300 deductible per individual/$550 per family that must be met each calendar year. Once the deductible has been met, the plan will pay 80% of the usual and customary fee. The employee is responsible for the remaining 20% copay, which is the coinsurance, and any amount charged over the usual and customary fee. The out-of-pocket maximums are $2,000 for Single and $4,000 for Family. Non-emergency in/outpatient procedures require precertification. In-plan (HMO) providers are responsible for precertifying procedures. A procedure scheduled by out-of-plan providers requires the member and/or the doctor to obtain precertification. Please note: The member has the ultimate responsibility to obtain precertification for procedures performed by out-of-plan providers. Medical Plan Opt-Out Provision: The County offers employees who have other medical benefits through another medical plan or coverage through the County as a result of marriage to another County employee or retiree the opportunity to earn a credit. The medical opt-out credit is $15.38 per payday or $400 annually. Proof of other coverage must be provided (a copy of your medical card). Prescription Plan Coverage: Express Scripts is the Countys administrator for the Countys prescription plan. You can contact them at 1-800-711-0917 or www.Expressscripts.com Coverage is available at participating retail pharmacies. The prescription plan has an annual deductible of $50 per individual. This must be satisfied prior to any plan coverage. The plan has a mandatory generic requirement that provides coverage of generic only for brand medications that have a generic alternative. A plan participant can still opt to receive a brand medication; however, the prescription plan will only provide coverage that equates to the amount of the generic alternative. The plan participant will be responsible for the copayment for a generic plus the cost difference between the brand and generic medication. The retail pharmacy provides a 30-day supply of your prescription. The following co-payments apply: Generic is $10; Formulary is $20 or 20% of the cost of prescription, whichever is greater, up to a maximum of $50. Non-formulary is $40 or 30% of the cost of the prescription; whichever is greater, up to a maximum of $50. There is a Mandatory Mail Order requirement on all maintenance medication(s). See the information outlined below for details on Mandatory Mail Order. Diabetic supplies (needles, syringes, lancets and test strips) are covered with $10 co-pay. Glucose monitors must be obtained through your medical plan provider. The prescription plan includes a Preferred Drug Step Therapy (PDST) program. The PDST program targets certain drugs in specified categories that are interchangeable with good generic alternatives. The prescription plan has a Prior Authorization Program in place that requires a physician review to ensure that requested medications are being used appropriately for certain drug categories. (You may contact Express Scripts at the above stated telephone number to find out if your medication falls under this Program). Mail Order Service (Express Scripts by Mail): The mail order service provides you the only mechanism to receive a 90-day supply of prescriptions that are needed for long-term use (maintenance drugs). The 90-day prescription co-payments for Express Scripts by Mail are: Generic $20; Formulary $40 or 20% of the cost, whichever is greater, up to a maximum of $100; and Non-Formulary is $80 or 30% of the cost, whichever is greater, up to a maximum of $100. Mail Order Service (Express Scripts by Mail) continued: The prescription plan has a mandatory mail order requirement on all maintenance medication(s). The requirement will allow you to get two (2) fills for a maintenance medication at the retail pharmacy for the retail co-payments. After the second fill, the prescription plan will provide no coverage for the maintenance medication at the retail pharmacy and you will have to submit your prescription(s) to Express Scripts-by-Mail for coverage of the medication and the mail order co-payments will apply. Note: The $50 annual deductible must be satisfied prior to any plan coverage. Prescription Plan Opt-Out Provision: The County offers employees who elect not to have prescription coverage, enrolled in an outside plan or covered by the County as a result of marriage to another County employee or retiree the opportunity to earn a credit. The prescription opt-out credit is $7.69 per payday or $200 annually. Proof of coverage is not required. Vision Plan Coverage: The vision coverage is administered by Vision Service Plan (VSP) and is designed to protect your visual wellness. The plan offers the option of using participating doctors or a doctor of your choice. Eye examinations are covered every year. The participant will pay$10 co-pay for the routine eye examination. Lenses for glasses and contact lenses are covered every year. The allowance of $150 is for the purchase of the contact lenses and the fitting/evaluation fee. Frames are covered every other year. Dental Plan Coverage: Dental Maintenance Organization (DMO): Aetna is the carrier for the Countys Dental Maintenance Organization (DMO) plan. This is a pre-paid dental plan with private practice general dentists and specialists who participate with the plan. You must utilize a participating dentist for this plan. The plan requires you to pay various copayments to receive preventive, basic and major services. The plan provides dental services such as, routine cleanings (every 6 months), x-rays, routine extractions by a general dentist and most fillings. Preferred Provider Option (PPO): Aetna administers the Countys dental Preferred Provider Organization (PPO) plan. The PPO plan allows employees to use a participating dentist (in-network) and provides the flexibility of utilizing a non-participating dentist (out-of-network). When using a participating dentist, preventive and basic services are covered at 100% and major services are covered at 60%. When using a non-participating dentist , there is a $25 deductible. Preventive and basic services are covered at 100% of the usual and customary rate and major services are covered at 50% of the usual and customary rate. Life Insurance Coverage: Basic life insurance coverage is administered through Aetna and is equal to two (2) times the basic annual salary, which is effective on the date of hire. There is a maximum amount payable for the Basic life insurance which is based on the employees salary schedule. There is no cost to the employee for the basic life insurance coverage. Coverage can be reduced to one (1) times the salary. The effective date of coverage is the date the employees health benefit plans becomes effective. The life opt-out credit can be added to the employees paycheck as taxable income or used towards purchasing other health benefit plans. Supplemental Life Insurance (SLI) is also administered through Aetna and is equal to 50 times the monthly salary and is effective on the date of hire. This benefit has a maximum of $300,000, which includes both basic and supplemental life insurance. SLI applies only to police officers, firefighters, paramedics, emergency response technicians and deputy sheriffs. Extra Life Insurance (XLI) can be purchased up to four (4) times the base salary, to a maximum of $600,000. Amounts of insurance coverage over $300,000 require the completion of an Evidence of Insurability (EOI) Form. The EOI process could result in a medical examination and the employee must utilize a provider or facility designated by Aetna for the exam. It is the responsibility of the employee to pay the cost of the medical examination. Cost is based on salary and age category. Deductions for XLI amounts are taken once (1) a month (first [1st] pay period) on an after-tax basis. An employees insurance amount and premium change automatically with the effective date of a salary increase and age category change. Internal Revenue Service (IRS) regulations limits to $50,000 the amount of group term life insurance the County can provide on a tax-free basis. Any value over $50,000 will be treated as taxable income based on an IRS imputed life chart. Accidental Death and Dismemberment (AD&D) benefit is administered through Aetna. It is an employer paid benefit. Flexible Spending Accounts: The Health Care and Dependent Care Flexible Spending Accounts (FSAs) administered by ConnectYourCare , allow pre-tax dollars to be placed in an account during the plan year (January 1 to December 31) to pay out-of-pocket expenses relating to health or dependent care. A 2½-month grace period will apply to the FSAs. If monies remain at the end of the plan year, participants will have until March 15th of the next plan year to incur an expense and use the remaining monies. These accounts must be renewed each year during open enrollment for the following plan year. If a new Enrollment Form is not received, the FSA will be cancelled. The period to file a claim is 120 days (April 30th) after the plan year ends. Health Care: A maximum of $2,500 may be set aside each year. A participant can be reimbursed for eligible out-of-pocket expenses not covered by a medical, prescription, vision or dental insurance plan for an employee and all eligible dependents. A participant can be reimbursed for eligible expenses by completing a Claim Form and attaching receipts and submitting both to the plan administrator. You have until April 30th of the calendar year after you terminate from County service to submit claims for eligible expenses incurred prior to and including the date of your termination. The Health Care Flexible Spending Account is eligible for continuation under COBRA. Dependent Care: A maximum of $5,000 may be set aside each year. A participant can be reimbursed for eligible childcare expenses for dependent children under the age of 13. The account also covers individuals (including a parent), who according to the IRSs definition of a dependent, is physically or mentally incapable of caring for his or her own needs and dependent upon the employee. Expenses claimed through the Dependent Care Spending Account (DCSA) may not be claimed on a tax return at the end of the year. You have until April 30th of the calendar year after you terminate from County service to submit claims for eligible expenses incurred prior to and including the date of your termination to ConnectYourCare. Long-Term Disability (LTD): Long-Term Disability (LTD) is administered by Aetna in two (2) groups -- Public Safety and Non-Public Safety Employees. This coverage provides two-salary replacement options of either 50% or 60% of base pay up to the allowable maximum per month in the event of a disability. The benefits will be reduced by other income benefits such as workers compensation, Social Security and disability retirement benefits. Benefits will begin after 180 days of disability. This is a voluntary benefit program. The employee pays 100% of the premium cost based on an insurance premium rate times their annual salary. Deductions are taken once (1) a month (first [1st] pay period) on an after-tax basis. An employees premium amount changes automatically with the effective date of a salary increase. A 12-month waiting period applies to any pre-existing conditions. New employees are eligible to enroll in the Long-Term Disability Plan at the time of hire without completing an Evidence of Insurability (EOI) Form. The EOI process could result in a medical examination and the employee must utilize a provider or facility designated by Aetna for the exam. It is the responsibility of the employee to pay the cost of the medical examinations. For additional information, you can contact the LTD Hotline, 1-866-326-1380 at Aetna. Employee Assistance Program (EAP): A confidential counseling and referral service for employees, dependents and household members. The EAP can assist with family, financial, work and personal issues. Counselors are available to talk with you and your household members on the telephone or in person. The plan provides up to eight (8) counseling sessions. Easy access to service 24 hours a day, seven (7) days a week via 877-334-0530, a toll-free number. Voluntary Benefit Plans The County has the following voluntary benefit plans listed under the Employee Health Benefits Program. These plans are in addition to the health benefit plans provided by the . County. Effective January 1, 2014, the plans are closed to new enrollments except the Aflac Supplemental Dental plan. The current design structure of the plans are as follows: *Short-Term Disability (STD): This coverage provides two-salary replacement options of either 50% or 60% of your salary in the event of a disability due to a covered off-the-job accident and/or illness including maternity. Deductions are taken bi-weekly on an after-tax basis. This is a voluntary benefit program. The employee pays 100% of the premium cost based on age, monthly benefit and elimination period selected. The elimination period (the time you will have to be off work before your STD benefits begin) and a monthly benefit that will meet your financial need is selected by you. The individual policy outlining the details of the plan will be sent to the address on file for you. If you terminate employment with the County, you can convert to direct bill and pay the same premium rate. *Permanent Whole Life Insurance: This plan provides life insurance for a spouse, children, grandchildren and/or yourself. The plan is in addition to your County-provided Basic, Supplemental, and/or Extra Life Insurance and it provides a death benefit as well as it builds cash value and earns interest. Deductions are taken bi-weekly on an after-tax basis. This is a voluntary benefit program. The employee pays 100% of the premium cost. The plan bases the amount of the policy (payable upon your death) on age and smoking/non-smoking status. You may cover your dependents even if you do not elect coverage for yourself. The individual policy outlining the details of the plan will be sent to the address on file for you. If you terminate employment with the County, you can convert to direct bill and pay the same premium rate. *Critical Illness Insurance Plan: The plan pays a lump sum benefit at the first diagnosis of a covered critical illness. Illnesses covered by the base plan include: heart attack, stroke, major organ transplant, permanent paralysis and other covered illnesses. Illnesses covered by the cancer rider include: cancer and carcinoma in situ (pays 25% of lump sum benefits). This plan is in addition to health insurance, sick pay and disability benefits and you are allowed to use the benefit payment, however you choose. Deductions are taken bi-weekly on an after-tax basis. This is a voluntary benefit program. The employee pays 100% of the premium cost that is based on age, tobacco status and the benefit amount selected. Family coverage options are available for spouse and children. Benefits may be subject to pre-existing condition limitations. The information outlining the details on this individual policy will be sent to the address on file for you. If you terminate coverage with the County, you can convert to direct bill and pay the same premium rate. *Accident Insurance Plan: This plan provides 24-hour coverage for accidents or injuries incurred on or off the job and payments can be used, however you choose. The plan helps with out-of-pocket expenses such as, deductibles, co-payments, and non-medical costs associated with a covered accident or injury. Some examples of covered injuries include, but are not limited to, burn, concussion, fracture, laceration and ruptured disc. Examples of covered benefits include, but are not limited to, ambulance service, Emergency Room (ER) treatment, hospital admission and surgery. Deductions are taken bi-weekly on an after-tax basis. Family coverage options are available. Spouses and dependent children (under age 21, or age 23, if still a full time student) are eligible, if the employee applies for coverage. The information outlining the details on this individual policy will be sent to the address on file for you. If you terminate coverage with the County, you can convert to direct bill and pay the same premium rate. *Cancer Indemnity Plan : Pays initial diagnosis benefit of $5,000. Pays $75 for annual wellness checkups. Pays cash benefits for radiation and chemotherapy. No cost to a policyholder to add coverage for dependent children. Pays benefits for hospital confinement, hospice care, ambulance, lodging, nursing services and many more. The plan requires you to answer some health questions to enroll. Premium starts as little as $6.84 per week. The information outlining the details on this individual policy will be sent to the address on file for you. If you terminate your employment with the County, and were enrolled in the plan for at least one (1) month, you can convert to direct bill and pay the same premium. *Hospital Indemnity Protection: Coverage for illness and injuries twenty-four (24) hour coverage (on and off the job). Coverage of pregnancy and birth of child. Initial hospital confinement benefit of $600 for the first night for injuries and $500 for illness. Pays for surgeries (inpatient and outpatient). Pays for major diagnostic exams. Pays an annual wellness benefit. The plan requires you to answer some health questions to enroll. Premiums start as little as $9.39 per week. The information outlining the details on this individual policy will be sent to the address on file for you. If you terminate your employment with the County, and were enrolled in the plan for at least one (1) month, you can convert to direct bill and pay the same premium. *Personal Accident Indemnity: Twenty-four (24) hour injury coverage (on and off the job). Covers injuries resulting from accidents. Initial hospital confinement benefit of up to $1,650 for the first night. Specific-sum benefit up to $12,500 based on the severity of the injury. Pays an annual wellness benefit. Premiums start as little as $4.48 per week. The information outlining the details on this individual policy will be sent to the address on file for you. If you terminate employment with the County, and were enrolled in the plan for at least one (1) month, you can convert to direct bill and pay the same premium. *Group Legal Insurance: A wide variety of legal services are covered in full for your monthly fee. Some services covered at 100% include, credit problems, family law, traffic violations and preparation of wills. Deduction is $18 per month on an after-tax basis the first pay period of the month. There are no co-payments, deductibles or restrictions on use and this plan provides coverage for yourself and qualified dependents. (Dependents ages 19-23 must be full-time students). The current plan design has a requirement that an employee must remain in the plan for twelve (12) months whenever enrollment in the plan occurs. You will be required to select a law firm from the administrators network. Attorney fees not covered in full are provided at a 25% discount. *Note: At this time, the Office of Human Resources Management (OHRM) is pursuing the procurement process for the voluntary benefit plans. Effective January 1, 2014, no new enrollments are being accepted in the plans except for the Aflac Dental Supplemental Insurance plan. The design of the plans may be modified and/or enhanced as a result of the procurement process. Supplemental Dental Insurance: Supplemental Dental Insurance is administered by Aflac . Choose your own dentist. Aflac does not use a network of dentists. There are no precertification requirements. Your dentist and you choose the treatment. There are no deductibles. Pays an annual wellness benefit. Premiums start as little as $5.73 per week. This plan works in conjunction with the Countys dental plan(s) and/or any other outside dental plan you may be enrolled. Aflac will send you information outlining the details on this individual policy to the address on file for you. If you terminate employment with the County, and were enrolled in the plan for at least one (1) month, you can convert to direct bill and pay the same premium. New employees are eligible to enroll in the Supplemental Dental Insurance at the time of hire or during open enrollment. For additional information, you can contact Aflacs Customer Service at 301-875-6397 or 1-800-992-3522. 01 (MQ1) I understand that I am applying for a career as a CROSSING GUARD with Prince George's County and not applying for just some job. Further, I acknowledge, understand and certify that: (a) this application is an OFFICIAL DOCUMENT that will be used to determine if I meet the selection requirements mandated by Federal, State, and County laws and regulations; (b) I will carefully and thoroughly read and answer ALL questions honestly and without error; and (c) my ability to successfully complete this Application and the Supplemental Questions is one of the requisite skills to be considered for this position. Yes No 02 (MQ2) I acknowledge, understand and certify that: (a) this application is an OFFICIAL DOCUMENT that will be used to determine if I meet the selection requirements for this position as mandated by Federal, State, and County laws and regulations; (b) I will carefully and thoroughly read and answer ALL questions honestly and without error; and (c) provide complete and truthful answers to all parts of this application, supplemental questions, and all documents required by the County; (d) participate in all of the selection and evaluation processes required for this position; and (e) save and review the information I provided in this application often because I will not try to claim that any mistakes or errors were made later. I understand that failure to do so will result in being PERMANENTLY DISQUALIFIED from consideration for any Public Safety position with Prince George's County. I also understand that should I be offered employment and accept a position with Prince George's County and subsequently it is discovered that any information I provided is false that I may be terminated from employment. Yes No 03 (MQ3) I will: (a) provide complete and truthful answers to all parts of this application and supplemental questions; (b) participate in all of the selection and evaluation processes required for this position; and (c) save and review the information I provided in this application often because I will not try to claim that any mistakes or errors were made later. I understand that failure to do so will result in being PERMANENTLY DISQUALIFIED from consideration for any Public Safety position with Prince George's County. I also understand that should I be offered employment and accept a position with Prince George's County and subsequently it is discovered that any information I provided is false that I may be terminated from employment. Yes No 04 (MQ4) What is your current age? Less than 18 years old Greater than 18 years old 05 Please provide your full name to include middle name and any other names you have used or are known by. Examples are maiden names, names by a former marriage, name changes, nicknames, other names you commonly use, etc. Separate each with a comma. 06 What languages are you fluent in? (select all that apply) English Spanish Korean Vietnamese Sign Language Other 07 (MQ5) I am willing to undergo a comprehensive background investigation, including contacts with all my references, employers, co-workers, close personal associates, etc., and a review of my driving record, credit and financial history, criminal history, educational history, and military service as well as undergo a polygraph, psychological evaluation, physical examination, and drug testing. Yes No 08 (MQ6) Are you a United States citizen or resident alien and can submit proof of citizenship or legal residency? Yes No 09 (MQ7) I acknowledge that: (a) this process is highly competitive; (b) there are many highly qualified applicants for only a few positions; (c) every step in the process, and all interaction with any County personnel, is designed to assess my character, comprehension and abilitites to determine if I have the aptitude and suitability for this position; and (d) some of my answers may automatically disqualify me PERMANENTLY so I have carefully checked all answers and saved my work regularly, so that I can attest there are no errors or mistakes in this application. Yes No 10 (MQ8) I acknowledge fully reading and understanding the instructions in the position announcement and did NOT use a mobile device, such as a phone, tablet or pad, to prepare and submit any part of this application. Followed the instructions Did not follow the instructions 11 (MQ9) Which best describes your HIGHEST level of education? You must have at least a High School diploma or GED in order to apply. None High School Diploma or GED Some College (less than 60 credit hours) Completed 60 Credit Hours of College Associate's Degree Bachelor's or Advanced Degree 12 (MQ10) I CERTIFY that I have not requested anyone to prepare and/or submit any part of this application on my behalf. Yes No 13 (MQ10A) I, as the applicant, am the only person that has provided any information in this application. I understand and willingly accept that I will be PERMANENTLY DISQUALIFIED for a Public Safety position if anyone has completed any part of this application on my behalf. Yes No 14 (MQ11) I will update my online profile with any changes to my personal information as soon as they occur. I will also check my online profile regularly, including the email account I provided, because I understand that all information, notices and scheduling regarding this application and evaluation process will be provided only in my online profile and/or through the email account I provided. Yes No 15 (MQM1) Male Applicants Only. Have you registered with Selective Service? Please click to obtain your Selective Service Number and Date of Registration. Yes No Active Duty or Previous Military Not Applicable 16 (MQM2) Male Applicants Only. Please provide your Selective Service Number and Date of Registration: 17 In the space provided below please list ALL Public Safety Agencies you have applied to within the last 5 years. Include agency name, date of application and disposition or current status. If not applicable, please put N/A. 18 (MJ1) How many times have you used, tried, ingested, inhaled or experimented with marijuana? I have NEVER used, tried, ingested, inhaled or experimented with marijuana 1 or more times but less than 25 times 26 or more times but less than 50 times 51 or more times but less than 75 times 76 or more times 19 (MJ2) How many years has it been since you have used, tried, inhaled, ingested or experimented with marijuana? I have NEVER used tried, inhaled, ingested or experimented with marijuana One year Two years Three years More than five years 20 (MJ21) Since your 21st birthday , how many times have you used, tried, or experimented with marijuana? I am NOT 21 yet 0 times 1 or 2 times 3 or 4 times 5 or more times 21 (DRG2) How many times have you used, tried, inhaled, ingested, injected or experimented with cocaine? If yes, please explain in question 46 . I have NEVER used, tried, inhaled, ingested, injected or experimented with cocaine. 1-2 times 3 or 4 times 5 or more times 22 (DRG3) How many times have you used, tried, inhaled, ingested, injected or experimented with Heroin, PCP, LSD, or other hallucinogens? If yes, please explain in question 46 . I have NEVER used, tried, inhaled, ingested, injected or experimented with Heroin, PCP, LSD, or other hallucinogens. 1 or 2 times 3 or 4 times 5 or more times 23 (DRG4) How many years has it been since you used, tried, inhaled, ingested, injected or experimented with narcotic drugs not prescribed to you for the purpose of getting high ? If yes, please explain in question 46 . I have NOT used, tried, inhaled, ingested, injected or experimented with narcotic drugs not prescribed to me for the purpose of getting high. One year Two years Three years More than five years 24 (DRG5) How many years has it been since you used, tried, inhaled, ingested, injected, or experimented with any drug or substance for the purpose of getting high? If yes, please explain in question 46 . I have NOT used , tried, inhaled, ingested, injected, or experimented with any drug or substance for the purpose of getting high within the last three years. One year Two years Three years More than five years 25 (DRG6) How many times have you used, tried, inhaled, injected, ingested, experimented with synthetic drugs in any form? If yes, please explain in question 46 . I have NEVER used, tried, inhaled, injected, ingested, experimented with synthetic drugs in any form. 1-3 Times 4-5 Times 6 or more times 26 (DRV1) Do you have a valid motor vehicle driver's license and at least 6 months driving experience? Yes No 27 (DRV2) Do you currently have 6 or more negative points on your Maryland driver's license, or the equivalent for out of state licenses? Yes No 28 (DRV3) In the last 3 years , have you been convicted of, or plead guilty to any DWI or DUI charge? Yes No 29 (DRV4) How many times have you been convicted of, or plead guilty to a DWI or DUI charge? 0 times 1 time 2 times 3 or more times 30 (DRV5) Are you currently awaiting any pending traffic proceedings? If yes, please explain in question 31 . Yes No 31 (DRV5A) If you answered yes to the question 30 , please explain. If no, put N/A. 32 (CRM1) How many times have you sold or distributed any illegal drugs? I have NEVER sold or distributed illegal drugs 1 or 2 times 3 or 4 times 5 or more times 33 (CRM1A) If you answered yes to the question 32 regarding theft, please explain. If no, put N/A. 34 (CRM2) Are you currently on probation or parole, have any outstanding warrants, or are awaiting any pending criminal proceedings? If yes, please explain in question 35 . Yes No 35 (CRM2A) If you answered yes to the question 34 , please explain. If no, put N/A. 36 (CRM3) Have you ever been convicted, entered a guilty plea or been given Probation Before Judgement (PBJ) for an assault that occurred in a domestic setting? If yes, please explain in question 37 . Yes No 37 (CRM3A) If you answered yes to the question 36 , please explain. If no, put N/A. 38 (CRM4) Have you ever been convicted of, or pled guilty to, a felony? If yes, please explain in question 39 . Yes No 39 (CRM4A) If you answered yes to the question 38 , please explain. If no, put N/A. 40 (CRM5) Have you ever stolen anything of value? I have NEVER stolen anything Yes, but it was worth less than $100 Yes, it was worth more than $100 but less than $500 Yes, it was worth more than $500 but less than $1,000 Yes, it was more than $1,000 41 (CRM5A) If you answered yes to the question 40 regarding theft, please explain. If no, put N/A. 42 (MQ12) If hired, I am willing and able to work any shift I may be assigned on any day of the week, including holidays and weekends. I also understand that I am an essential employee and will always report to work on time regardless of weather or other circumstances. Yes No 43 (MQ13) Being a professional contract employee requires organization and teamwork. Are you willing and able to adhere to County and Departmental rules and regulations; to take orders from superiors; and to work with fellow team members who are of different nationalities, gender, age, sexual orientation, religious beliefs, and econonic, educational or social backgrounds? Yes No 44 (MQ14) Prior to submitting my application for this position, I CERTIFY that: (a) I have THOROUGHLY reviewed my entire application and ALL of the answers I have provided to all of the questions and have verified that ALL of the information is complete, honest and accurate; (b) I have CORRECTED any and all errors, mistakes and/or omissions, and will not claim that any of my answers were mistakes or made in error; and (c) I have CAREFULLY read and completely understand the position announcement. Yes No 45 (MQ15) Since I have CERTIFIED that I have not made ANY mistakes in my answers to these questions, and I have CAREFULLY checked all of my answers and corrected ANY errors, I will ACCEPT the consequences that result from the information I have provided. Yes No 46 In the space provided below, please completely explain your history with using, or experimenting with any drugs, marijuana, or other controlled substances, whether legal or illegal, prescribed or not prescribed, etc., for the purpose of getting high. You must include detailed information on: 1) what you used; 2) how many times you used it; 3) when you used it (month/year); and 4) any other important information we should know about your drug or marijuana use. Please note that if you progress through the process your statements here will be subject to a truth verification examination, such as a polygraph, etc. Required Question Agency Prince George's County Government Address 1400 McCormick Drive, Suite 159 Largo, Maryland, 20774 Phone (301) 883-6330 (301) 883-6330 Website