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Supplemental Questions
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You will be required to answer these questions as part of the application process.
  1. Please list your social security number
  2. Please list your diver's license number, state it was issued and expiration date
  3. (Optional) In order to run your background check, please provide your date of birth
  4. Are you related to a City of Liberal employee?(blood or marriage) If so, please list their name
  5. Have you ever used any other name?
  6. Have you ever used a false Social Security number?
  7. Are you currently experiencing any financial problems?
  8. Are you currently behind on any debts?
  9. Do you owe any back taxes?
  10. Have you ever had any property repossessed?
  11. Have you ever had any bill turned over to a collection agency?
  12. Have you ever skipped out on a debt?
  13. Have you ever had a bad credit rating?
  14. Is there anything in your financial background we need to discuss?
  15. Do you know the amount of your total indebtedness now?
  16. Approximately how much money do you owe now?
  17. Have you ever been refused credit?
  18. Can you pay your present debts on what you will earn from this department?
  19. Are you intentionally withholding any information about your financial status?
  20. Have you ever been involved in a lawsuit?
  21. Do you currently have any lawsuits pending?
  22. Do you know the starting salary of this job?
  23. What is the starting salary?
  24. Are you satisfied with the starting salary of this job?
  25. Do you know of any reason that would cause you to leave this job within three years?
  26. Do you consider yourself a reliable employee?
  27. Why?
  28. Would you report a friend or relative who was involved in any illegal activity?
  29. Why?
  30. Do you have any friends or relatives who are involved in any illegal activity?
  31. Has anything illegal ever occurred in your presence?
  32. Have you applied for any other jobs as a law enforcement officer:
  33. Where?
  34. Do you have any other employment applications pending?
  35. Are you currently working?
  36. Where?
  37. How many jobs have you had in the past five years?
  38. Do you have any other sources of income?
  39. Explain?
  40. Have you correctly listed all your past jobs on the employment application (including part time jobs)?
  41. Are there any problems with your present job that is causing you to leave?
  42. What are they?
  43. Have you ever had any problems with a supervisor?
  44. Have you ever been fired from a job?
  45. Have you ever been asked to resign from a job?
  46. Have you ever left a job to avoid being fired?
  47. If so, what reason resulted into resigning?
  48. If you know, will any past employers have anything negative to say about you?
  49. If you know, has any employer ever given you a bad recommendation?
  50. Did you leave any jobs off your employment application with this agency?
  51. Have you ever left a job without giving notice?
  52. Are there any past employers that would not hire you back?
  53. Why?
  54. Are you deliberately withholding any information about your employment history?
  55. If so, what?
  56. Have you ever had any serious trouble at work?
  57. How many times have you been late for work in the past 12 months?
  58. Have you committed any serious violations of employer rules or regulations?
  59. Have you ever falsified an insurance claim?
  60. Have you ever falsified an expense account?
  61. Have you ever consumed beer or alcohol while on the job?
  62. Have you ever been at work while under the influence of beer or alcohol?
  63. Has the use of beer or alcohol ever interfered with your work?
  64. Are you currently registered for the draft?
  65. Have you ever served in the Armed Forces?
  66. What were your dates of service?
  67. What was your rank at the time of discharge?
  68. Did you receive any disciplinary action while in the service?
  69. Are you currently a member of a Reserve Unit?
  70. Do you have a copy of your DD-214?
  71. Did you ever steal any government property?
  72. When discharged, did you keep any government property?
  73. Have you ever committed a crime for which you were not caught?
  74. If so what?
  75. Have you ever been arrested as an adult?
  76. Do you have any criminal charges as a juvenile or adult that have been expunged or dismissed?
  77. Have you ever been picked up by the Police?
  78. Have you ever been detained by a Police Officer?
  79. Are you currently wanted by the Police?
  80. Have you ever committed an undetected crime?
  81. Have you ever committed a serious undetected crime?
  82. Do you have any information about a crime?
  83. Are you aware of any criminal activity in this area?
  84. Have you been involved in any criminal activity in the past 3 years?
  85. Have you ever been arrested for any drug violation?
  86. Have you ever committed, conspired to commit, or participated in any serious crimes?
  87. Have you ever stolen money?
  88. Have you ever broken into a building?
  89. Have you ever switched price tags?
  90. Have you ever switched price tags?
  91. Have you ever received a kickback?
  92. Have you ever paid a kickback?
  93. Have you ever received a bribe?
  94. Have you ever stolen property from a vehicle?
  95. Have you ever bought, possessed or sold stolen property?
  96. Do you now have any property that may be stolen?
  97. Have you ever been picked up by the Police for a prostitution related offense?
  98. Have you ever illegally used a credit card?
  99. Have you ever stolen cash or merchandise from an employer?
  100. Have you ever illegally used cocaine?
  101. Have you ever illegally used marijuana?
  102. Have you ever sold illegal drugs?
  103. Have you ever illegally used amphetamines or barbiturates?
  104. Have you ever helped buy or bought illegal drugs for a friend?
  105. Have you illegally used another person’s prescribed medicine?
  106. Have you illegally used any other type of drugs not mentioned?
  107. When was the last time you were present when illegal drugs were being used?
  108. Have you ever committed bestiality?
  109. Have you ever forced someone to commit an illegal sex act?
  110. As an adult, have you ever been sexually aroused by a child?
  111. As an adult, have you ever had sexual contact with someone under the age of 16?
  112. Have you ever exposed yourself?
  113. Have you ever experimented sexually with any kind of animal or anything other than human?
  114. Have you ever raped or sexually assaulted anyone?
  115. Have you ever looked through a window to watch someone undress?
  116. As an adult, have you been involved in any criminal activity?
  117. Have you given company merchandise or property away?
  118. Have you ever cheated an employer?
  119. Have you ever falsified your employer’s records?
  120. Have you ever falsified your time card?
  121. Have you ever been paid for work you did not perform?
  122. Have you ever been involved in an illegal theft ring?
  123. Have you ever shoplifted anything?
  124. Have you ever been the subject of a criminal investigation?
  125. Have you ever been an inmate in a jail or correctional facility?
  126. Have you ever been refused a security clearance?
  127. Have you ever written a check when you knew you did not have enough money in the bank to cover it?
  128. Have you ever signed someone else’s name to a check?
  129. Have you ever used a credit card that did not belong to you?
  130. Do you have automobile insurance?
  131. Have you ever had your insurance rated or canceled?
  132. Do you have a valid driver’s license?
  133. Do you have more than one driver’s license?
  134. How many years experience do you have in operating a motor vehicle?
  135. Have you ever falsified your age on a motor vehicle department document?
  136. Have you had any tickets in the past three years?
  137. Have you been involved in any accidents in the past five years?
  138. Do you have any unpaid tickets?
  139. Have you ever been involved in an accident and not reported it?
  140. Has anyone ever died or gone to the hospital as a result of an accident in which you were the driver of the car?
  141. Have you ever had your driving privileges suspended?
  142. Have you ever had your driving privileges revoked?
  143. Have you ever operated a motor vehicles while under the influence of alcohol or beer?
  144. Have you ever driven someone’s car without permission?
  145. Have you ever been arrested for a DUI?
  146. Have you ever been ticketed for reckless driving?
  147. Do you gamble on: Sporting events, Football Pools,Horses, or dogs? please explain
  148. What is the most money you have won or lost gambling?
  149. Have you ever bet with a bookmaker?
  150. Have you ever-owed money to a gambler?
  151. Do you owe any money on a gambling debt now?
  152. Do you know anyone who makes book?
  153. Do you know where someone could place an illegal bet?
  154. Do you know of any reason why you should not take this polygraph test?
  155. Have you ever faked an injury?
  156. How many sick days did you use last year?
  157. Have you been in any fights in the past two years?
  158. Does any of your immediate family work for this agency?
  159. Has any of your immediate family worked for this agency?
  160. Has any of your immediate family been arrested?
  161. Has any of your immediate family been convicted of a crime?
  162. Has any of your immediate family been in prison?
  163. Is there anything in your background that could embarrass this agency?
  164. Is there anything in your background that you could be blackmailed for?
  165. Is there anything in your background that you are afraid to discuss with the examiner?
  166. Have you deliberately falsified any of the information provided to this agency or this examiner?
  167. I understand and have answered truthfully to each of the questions on this interview. I also understand that false information may disqualify me for this job or cause my termination, if hired. Please print your name and date in the free form section as a electronic signature
  168. THE FOLLOWING QUESTIONS ARE TO BE ANSWERED BY THOSE APPLICANTS WITH PRIOR POLICE, SECURITY, OR SECURITY RELATED EXPERIENCE. IF YOU HAVE BEEN INVOLVED IN LAW ENFORCEMENT IN ANY CAPACITY, INCLUDING POLICE, CORRECTIONS, COURTS, AND MILITARY SERVICE, COMPLETE THE FOLLOWING: please select yes if you have prior experience
  169. Yes
    No
  170. What law enforcement experience do you have?
  171. List all of the agencies you have been employed by
  172. Have you ever falsified a police report?
  173. Have you ever lied under oath?
  174. Have you ever kept evidence?
  175. Have you ever failed to turn in any evidence?
  176. Have you ever stolen merchandise or property from a place where you were conducting an investigation?
  177. Have you resigned from a police agency to avoid prosecution?
  178. Have you ever given drugs to an informant?
  179. Have you ever planted evidence on anyone?
  180. Have you used any illegal drugs since becoming a law enforcement officer?
  181. Are you currently certified as a law enforcement officer by the State of Kansas?
  182. Have you graduated from a State approved law enforcement training program?
  183. While working as a law enforcement officer, have you failed to complete a probationary period?
  184. Has your probation ever been extended? if so, Please explain why
  185. Has your supervisor ever placed you on probation?
  186. Are you currently on probation?
  187. Have you ever been sued for something you did or failed to do as a law enforcement officer?
  188. Are there any civil or criminal actions pending against you now for something you did or failed to do as a law enforcement officer?
  189. Have you received any commendations?
  190. Has anyone ever filed a complaint against you?
  191. Have you ever received a letter of reprimand?
  192. Have you ever been suspended?
  193. Have you ever kept found property?
  194. Have you ever failed to turn in found property?
  195. Have you ever conducted an illegal search?
  196. Have you physically abused a prisoner, arrestee, or anyone otherwise detained?
  197. Have you been present when a prisoner, arrestee, or anyone otherwise detained, was physically abused?
  198. Have you ever been the subject of an internal investigation?
  199. Have you ever lied during an internal investigation?
  200. Have you ever committed any violations of department policy?
  201. Have you ever engaged in sexual activity while on duty?
  202. Have you ever failed to perform your duty in exchange for sexual favors or in exchange for promises of sexual favors?
  203. Have you ever received free meals or coffee?
  204. Have you ever sought sexual favors in return for official action or inaction?
  205. Have you ever received anything of value because you were a Police Officer?
  206. Since becoming a Police Officer, have you used marijuana or other illegal drugs?
  207. Have you ever allowed unauthorized persons to ride in your police vehicle?
  208. Since becoming a Police Officer, have you committed an illegal act?
  209. Have you used your official position for personal gain?
  210. Have you ever committed an act that could result in suspension or termination?
  211. Have you ever received anything of value from a merchant?
  212. Have you ever discussed an investigation with unauthorized persons?
  213. Have you ever given criminal record information to anyone outside law enforcement?
  214. Have you ever covered up for a fellow officer?
  215. Have you ever lied to Internal Affairs?
  216. Have you ever discharged a firearm accidentally?
  217. Have you ever discharged a firearm in the line of duty?
  218. Have you ever discharged a firearm and not reported it?
  219. Did you ever stop a car and try to date the driver?
  220. Have you had sexual contact with a prostitute?
  221. Have you ever had sexual relations with someone while on duty?
  222. Did you ever carry a “drop or throw away gun?”
  223. Have you ever planted a weapon on a suspect?
  224. Have you been involved in any traffic accidents in a police vehicle?
  225. Have you ever lied about damage to department property?
  226. Have you ever fixed a ticket?
  227. Have you ever failed to write a ticket because of who the driver was?
  228. While in the academy, did you ever cheat on any tests or assignments?
  229. To insure you will pass this test, is there anything we should discuss?
  230. Is there anything in your professional or personal background you are afraid may disqualify you for this job?
  231. Is there anything in your professional background you are afraid may cause you to fail this polygraph test?
  232. Have you ever taken a polygraph test?
  233. I understand and have answered truthfully to each of the questions on this interview. I also understand that false information may disqualify me for this job or cause my termination, if hired. Please type your name on the free form as a electronic signature and date it.