City of Peoria Police Department CRITERIA STANDARDS FOR CONSIDERATION OF DISQUALIFICATION 1. ANY MISLEADING OR UNTRUTHFUL STATEMENTS DURING ANY PORTION OF THE TESTING AND/OR SCREENING PROCESS. 2. ANY FELONY CONVICTION OR OFFENSE THAT WOULD BE A FELONY IF COMMITTED IN ARIZONA 3. PARTICIPATION IN ANY SERIOUS CRIMINAL ACT. 4. DISHONORABLE DISCHARGE FROM THE US ARMED FORCES 5. ILLEGAL SALE, PRODUCTION, CULTIVATION, OR TRANSPORTATION OF MARIJUANA FOR SALE. 6. ILLEGAL SALE, PRODUCTION, CULTIVATION, OR TRANSPORTATION OF NARCOTICS OR DANGEROUS DRUGS FOR SALE. 7. AN ESTABLISHED PATTERN OF ABUSE OF PRESCRIPTION MEDICATION. 8. VIOLATION OF TRAFFIC LAWS WITH SUCH FREQUENCY SO AS TO INDICATE A DISRESPECT FOR TRAFFIC LAWS AND A DISREGARD FOR THE SAFETY OF OTHER PERSONS ON THE HIGHWAYS AND ROADWAYS WITHIN THE PAST THREE YEARS. 9. ANY SEXUAL ACT OR SEXUAL CONDUCT PROHIBITED BY LAW. 10. NEGLIGENCE IN MAINTAINING FINANCIAL RESPONSIBILITY. NOTE THAT THE FOLLOWING DRUG USE STANDARDS APPLY TO CIVILIAN EMPLOYEES 1) Marijuana Use: No use within the last three years; 2) Dangerous and Other Drugs: No use in the last five years; and 3) Hallucinogenic Drugs: No more than twice, and not in the past 10 years PLEASE CONFIRM THAT YOU HAVE READ, UNDERSTAND, AND AGREE TO THE AFOREMENTIONED CONDITIONS AND CRITERIA BY SIGNING BELOW. Signature____________________________________Date ______________________ PUBLIC DISCLOSURE OF INFORMATION Your Social Security Number is requested for identification and record keeping purposes. Disclosure of your social security number is for the purpose of conducting a thorough background investigation. The information included on this form may constitute a “public record of matter” requiring public disclosure under Arizona’s Public Records Law, A.R.S. 39-121 et seq.